Cortisone injections offer no lasting relief for chronic heel tendon pain, study finds
An Australian clinical trial published in The BMJ found cortisone injections do not provide sustained improvement for chronic heel tendon pain after one year.
Key Takeaways
AIA clinical trial published in The BMJ has found that cortisone injections did not provide lasting improvement in pain or mobility for patients with chronic heel tendon disorders after one year of treatment.
The study, conducted in Melbourne, Australia between 2019 and 2022, involved 192 adults with an average age of 49, whose symptoms had persisted for about two years on average.
Participants were randomly assigned to three groups: one received placebo injections, the second received high-volume injections without cortisone, and the third received high-volume injections containing corticosteroids (cortisone).
All participants followed a similar exercise program with guidance on modifying physical activity, and pain and mobility were measured using a specialized scale over 52 weeks.
Results showed that high-volume injections, whether or not they contained cortisone, did not produce clinically significant improvement compared to placebo after one year. A limited improvement was observed in the cortisone group at six weeks, but this did not last, and their results at 26 weeks were worse than those who received injections without cortisone. Injections without cortisone did not outperform placebo at any assessment point.
Final follow-up data were obtained from 181 participants (94% of the sample), and no serious adverse events related to the treatments were reported.
The researchers emphasized that the findings do not mean cortisone is unsuitable for all cases, but they question its routine use in treating chronic heel tendon disorders, especially if long-term improvement is the goal.
John Orchard from the University of Sydney cautioned against viewing corticosteroids as a universal solution or dismissing them entirely, stressing the importance of individual assessment. He also noted that pain relief does not necessarily indicate tendon healing.
Exercise and load modification remain key treatment methods, and patients should discuss the benefits and alternatives with their doctor before considering injections.