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Skin and Soft Tissue Infections

Injections of the Foot and Ankle

James Wilcox, MD
Sabrina Silver, DO
Kimbre Zahn, MD

American Family Physician. 2026;113(5):431-439.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

Foot and ankle injections are commonly performed by family physicians for the management of musculoskeletal conditions such as plantar fasciitis, osteoarthritis, interdigital neuromas, tarsal tunnel syndrome, and pathology of the first metatarsophalangeal joint. If symptoms persist despite conservative measures, injections may improve function and reduce pain. Before an injection, the clinician should discuss procedural risks, including pain, swelling, redness, stiffness, infection, and damage to surrounding tissues, and obtain informed consent. Corticosteroid injections can provide short-term pain relief for plantar fasciitis and first metatarsophalangeal joint arthritis, but they increase the risk of fascia rupture, fat pad atrophy, and cartilage damage. Platelet-rich plasma injections are supported by evidence that they may be beneficial in those with plantar fasciitis. Corticosteroid injections placed directly into weight-bearing tendons is not recommended because of the increased risk of rupture. Ultrasound guidance improves accuracy and reduces procedural risks such as neurovascular injury.

JAMES WILCOX, MD, CAQSM, RMSK, is an assistant professor of clinical family medicine in the Department of Family Medicine at United Arab Emirates University, Abu Dhabi, and an adjunct assistant professor of clinical family medicine in the Department of Family Medicine at Indiana University School of Medicine, Indianapolis.

SABRINA SILVER, DO, CAQSM, is a family medicine residency program director at Indiana University School of Medicine, Indianapolis.

KIMBRE ZAHN, MD, CAQSM, is an assistant professor of clinical family medicine in the Department of Family Medicine at Indiana University School of Medicine, Indianapolis.

Address correspondence to James Wilcox, MD, at jgwilcox@iu.edu.

Author disclosure: No relevant financial relationships.

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