Quick answer: Foot and ankle injections deliver a corticosteroid or anaesthetic directly into an inflamed joint, bursa or nerve, often under ultrasound guidance for accuracy. They relieve pain rather than cure the cause, so they work best alongside orthotics, footwear changes and rehab, and are limited in number to protect tendon and cartilage. Book online, or call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
Foot & Ankle Injections in Michigan Steroids, PRP  relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Township: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.
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Therapeutic injections are one of the most effective non-surgical tools in foot and ankle care — providing targeted pain relief, reducing inflammation, and in the case of PRP and prolotherapy, potentially promoting tissue healing. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki performs a range of foot and ankle injections, including ultrasound-guided injections for precision placement when anatomy or clinical judgment demands it.
Corticosteroid Injections
Corticosteroid injections (cortisone shots) are the most commonly performed therapeutic injections in podiatric practice. Corticosteroids are potent anti-inflammatory agents that reduce the local inflammatory cascade responsible for pain, swelling, and tissue sensitization. Common conditions treated with steroid injection include: plantar fasciitis (injected at the medial calcaneal insertion of the fascia); Morton’s neuroma (intermetatarsal space injection); bursitis (retrocalcaneal, submetatarsal); ankle joint arthritis (intra-articular injection); MTP joint capsulitis and gout; and tarsal tunnel syndrome (peri-neural injection). Relief typically begins within 48–72 hours and may last weeks to months. Repeated injections are limited — generally no more than 2–3 per year at any single site — to avoid soft tissue atrophy, cartilage damage, and plantar fascia rupture risk. Corticosteroid injection is avoided in the Achilles tendon body due to rupture risk.
Platelet-Rich Plasma (PRP) Injections
PRP is prepared from the patient’s own blood — a sample is centrifuged to concentrate the growth factor-rich platelet layer, which is then injected into the target tissue. Growth factors in PRP (PDGF, TGF-β, VEGF, IGF-1) are thought to stimulate tissue healing and modulate the chronic inflammatory state seen in tendinopathy and plantar fasciitis. PRP has the strongest evidence for mid-portion Achilles tendinopathy and plantar fasciitis that has failed corticosteroid injection and physical therapy — studies consistently show it outperforms corticosteroid at 6–12 month follow-up and does not carry the atrophy or rupture risks of repeated steroid use. One to three injections are typical. PRP is generally not covered by insurance and carries an out-of-pocket cost, which Dr. Biernacki discusses transparently with patients.
Hyaluronic Acid (Viscosupplementation) Injections
Hyaluronic acid injections deliver a gel-like lubricant into arthritic joints — most commonly the ankle, subtalar, or 1st MTP joint — to reduce friction, decrease pain, and improve range of motion. The mechanism combines mechanical lubrication with modest anti-inflammatory and chondroprotective effects. Evidence in the ankle joint is more limited than in the knee, where viscosupplementation is more established, but clinical experience supports its use for ankle and subtalar arthritis as an intermediate option between corticosteroid injection and surgical arthrodesis. A series of 3–5 weekly injections is typical.
Ultrasound-Guided Injections
In-office ultrasound guidance significantly improves injection accuracy for small or deep target structures. Studies demonstrate that ultrasound-guided injections are more accurate than landmark-based blind injections for the peroneal tendon sheath, Morton’s neuroma, subtalar joint, retrocalcaneal bursa, and plantar fascia enthesis. Greater accuracy translates to better outcomes and reduced risk of injection into unintended structures (e.g., inadvertent fat pad injection with plantar heel steroid). Dr. Biernacki uses ultrasound guidance for complex or small-target injections routinely.
Frequently Asked Questions
Do cortisone shots hurt?
A topical anesthetic (ice spray or EMLA cream) is often applied before injection to minimize discomfort. The needle insertion causes brief discomfort; the cortisone itself can cause a brief burning or stinging sensation. Most patients describe the experience as significantly less uncomfortable than they anticipated. Post-injection flares (24–48 hours of increased pain from the injection) occur in approximately 10–15% of patients and resolve on their own.
How long does a cortisone shot last for plantar fasciitis?
Cortisone injections for plantar fasciitis provide significant pain relief in approximately 70% of patients. Relief duration varies — some patients experience 3–6 months of benefit, others only 4–6 weeks. Longer-lasting relief is associated with concurrent use of custom orthotics, stretching, and activity modification. PRP injection tends to produce more durable results at 6–12 months for patients whose condition recurs after steroid injection.
Is PRP covered by insurance?
PRP injection is generally not covered by Medicare or most commercial insurance plans for musculoskeletal conditions (plantar fasciitis, Achilles tendinopathy) as of current guidelines. It is typically an out-of-pocket expense. Dr. Biernacki discusses PRP cost, evidence, and expected outcomes transparently so patients can make an informed decision. The cost may be covered under some supplemental or gap insurance plans.
How many injections can I get for foot pain?
The number of corticosteroid injections is generally limited to 2–3 per year at a single site due to risks of cumulative soft tissue atrophy, fat pad thinning, and plantar fascia weakening with repeated injections. There is no strict limit on the number of PRP injections, though most protocols use 1–3 injections with reassessment. Dr. Biernacki evaluates the response to each injection before recommending additional treatment.
Targeted injections can provide meaningful relief when combined with appropriate follow-up care. Contact Balance Foot & Ankle to discuss whether an injection is right for your condition with Dr. Biernacki in Southeast Michigan.
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About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Township, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
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Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-week appointment availability.
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.