A cortisone injection in the foot delivers a powerful combination of a corticosteroid medication and a local anesthetic directly to an area of inflammation. This treatment is often used for common foot conditions like plantar fasciitis, bursitis, or tendonitis to rapidly reduce swelling and pain. The immediate pain relief felt is primarily due to the anesthetic, which wears off quickly, while the steroid component begins its anti-inflammatory work over the following days. Proper post-injection care is necessary to ensure the medication remains localized and the treatment provides its maximum intended benefit.
Mandatory Rest and Initial Weight Bearing
The answer is yes; a period of mandatory rest is required, typically lasting between 24 and 48 hours immediately following the procedure. This initial restriction is necessary because the corticosteroid needs time to settle and begin binding to the inflamed tissues in the targeted area. Engaging in strenuous activity too soon can physically push the medication out of the precise injection site, reducing its concentration and effectiveness.
Since the foot is a major weight-bearing joint, minimizing pressure is especially important during this window. Patients should reduce walking and standing for the first two days, and doctors may advise against any high-impact activities. For some injections, temporary use of crutches or a walking boot may be suggested to protect the site and allow the steroid to work without mechanical interference.
Managing Local Discomfort
It is common to experience a temporary increase in pain once the initial local anesthetic wears off, which can happen a few hours after the injection. This sensation is often localized soreness or bruising from the needle itself, but it can also be a reaction known as a “steroid flare.” A steroid flare is a self-limiting inflammatory response caused by the body reacting to the injected steroid crystals, which can cause increased pain, warmth, and swelling at the site.
This flare occurs in up to 5% of injections and typically starts within 12 to 48 hours, resolving within one to three days. To manage expected discomfort, applying an ice pack wrapped in a towel to the injection site for 15 to 20 minutes several times a day can help reduce swelling and pain. Over-the-counter pain relievers like acetaminophen are generally approved for use, but non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be discouraged immediately post-injection, so confirm this with your doctor. Elevating the foot above the level of the heart for short periods can also assist in reducing local swelling.
Timeline for Returning to Full Activity
After the initial 48-hour rest period, the return to activity must be gradual to protect the healing tissue and allow the corticosteroid time to take full effect. Light walking and gentle daily activities can usually be resumed if they do not cause a return of the original pain. For weight-bearing joints like the foot, it is recommended to avoid high-impact activities such as running, jumping, or heavy exercise for one to two weeks.
The underlying condition being treated dictates the specific timeline, with ligament or tendon injections often requiring a longer period of modified activity. Low-impact activities like cycling or swimming can often be introduced after three to four days, focusing on exercises that do not stress the injected area. Any sharp or increasing pain is a clear sign to immediately reduce activity and consult with the injecting physician before progressing further.
When to Contact Your Doctor
While mild pain and a temporary flare are expected, certain symptoms require immediate medical attention. You should contact your doctor if you develop signs of infection, such as fever, persistent or spreading redness, warmth, or pus at the injection site. Severe pain that rapidly worsens after the first 48 hours, instead of showing improvement, is also a cause for concern. If you experience persistent or spreading numbness, tingling, or weakness in the foot or ankle, this could signal nerve irritation and should be reported without delay.