Tendon pathology in the foot. The use of corticosteroid injection therapy.

Corticosteroids have been used extensively in the practice of orthopedics and podiatry. It is the authors' opinion that the issue of corticosteroids and their effect on the healing of tendon pathology has not been addressed sufficiently or answered adequately. Few studies have used a well-controlled injury model. Steroid dosage and steroid selection also appear to be random. Clinical experience in conjunction with a complete review of the literature, however, leads the authors to believe that the use of local corticosteroid injection is a valid treatment option. Local injection for painful tendon pathology is a relatively simple, safe, and effective form of treatment. The patient may experience rapid relief of pain and swelling and, on occasion, may be able to return to normal activities after one injection. With the exception of the Achilles' tendon, it is the authors' opinion that the use of local corticosteroid injection for the treatment of tendonopathy is not only an option, but an effective means of therapy. Armed with a good understanding of tendon anatomy, proper injection technique, and differing types of corticosteroids, effective results are well within reach for the patient and physician. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs) or oral corticosteroids, injectable corticosteroids deal with the problem at the site, delivering needed relief while eliminating adverse systemic effects. This therapy is cost effective and has fewer potential complications than operative intervention.