What Is An Ankle Injection?

If you’re suffering from ankle pain, whether due to arthritis or an injury, you may want to consider an ankle injection, or corticosteroid injection of the ankle, to reduce your pain.

If you undergo one of these injections, the specialist will first start by administering medication, usually an anti-inflammatory agent (e.g., steroid) and a pain reliever (e.g., anesthetic), directly into your ankle joint and the surrounding soft tissue in the joint space. Inflammation and tissue damage from blunt force trauma or different conditions (e.g., osteoarthritis, bursitis) can lead to chronic and severe pain in the ankle. These injections can help.

Do I need an ankle injection? 

Your healthcare specialist may recommend this option if conventional methods (e.g., ibuprofen, aspirin) have not helped to relieve your ankle pain.

Further, if you’re having difficulty moving around or attending physical therapy, an ankle injection can help bridge the gap. That way, you can recover your normal activity and get in the process of improving your pain. Your healthcare specialist may also recommend an ankle injection if you’re experiencing any of the following while moving:

  • Extreme tenderness
  • Swelling
  • Popping and cracking sounds

In addition, they may recommend this procedure before attempting more invasive surgeries for chronic pain.

How can these injections help?

Ankle injections are not only used for therapeutic purposes, as when treating chronic pain. They can also help diagnose the origin of it.

An injection can help your doctor assess whether you could experience longer relief from a more invasive treatment method, such as a nerve block. A nerve block entails administering stronger medications into the ankle joint. These temporarily disrupt pain signal transmission from the targeted nerves or completely destroy the nerve tissue in the affected region.

If you find significant pain relief after two or more ankle injections, a nerve block could lead to long-term relief.

How Is An Ankle Injection Performed?

Ankle injections are non-invasive procedures. They can be performed in a few minutes.

A doctor first cleans the injection site and then applies topical anesthesia to the ankle. Next, they insert the injection needle into the targeted region.

Once they’ve confirmed proper placement, a corticosteroid, such as cortisone, and an anesthetic are injected into your ankle. The corticosteroid targets the inflammation and the anesthetic helps to provide pain relief. You may feel mild pressure and pain as they are inserting the needle.

These injections are considered safe, especially when the injection technique is handled by a highly-trained specialist who has performed many similar procedures.

What should I expect after? 

Always follow all medical advice in terms of rest and medication from your doctor. They know best about your particular case history and needs.

Typically, you’ll want to stay off of the affected ankle for at least a few days after receiving the injection to prevent unnecessary strain. Accordingly, if you have a job that requires them to stand or walk frequently, talk to your doctor about workplace modifications or PTO days you can take to reduce any strain on the ankle. You may also need to adjust your work habits so the ankle that was treated can be protected from excessive strain until discomfort diminishes.

Furthermore, if you’re experiencing more pain in the days following the procedure, you may be able to take over-the-counter pain relievers (e.g., ibuprofen). Cold compresses can also help. Apply them to the ankle for 20 minutes throughout the day in order to relieve temporary swelling and pain. Most patients experience significant pain relief one or two days after undergoing this procedure.

If you are still experiencing severe symptoms after the injection, report them to your doctor.

What Is An Ankle Injection, Or Ankle Cortisone Shot? | PainDoctor.com

Ankle injection side effects and risks

While rare, side effects and risks can occur. Talk to your doctor before the procedure about any of your risk factors or concerns that you have. Working with a highly-qualified specialist who performs these procedures regularly can reduce your risk. Typical side effects include bruising, bleeding, and tenderness at the injection site.

More severe ankle injection risks include:

  • Cartilage deterioration
  • A weakened or ruptured tendon
  • Possible puncturing of a vein or artery
  • An infection
  • Osteoporosis (thin bones)
  • Osteonecrosis (the death of nearby bone)

The Achilles tendon is also especially susceptible to injury. People who may have a higher risk of complications include those who have:

  • Blood or skin infections
  • A history of allergic reactions to injections
  • Autoimmune conditions that make it harder for them to fight off infections
  • Poorly controlled diabetes

In order to avoid the risks mentioned above, your doctor will typically limit the number of ankle injections a person can receive annually to three or four. You should also avoid taking any medications or herbal supplements that thin the blood a couple days before receiving the injection. This can the risk of bruising and bleeding at the injection site.

Conditions Related To Ankle Injections

Several conditions cause inflammation, tissue damage, and persistent ankle pain. These include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Tarsal tunnel syndrome
  • Bursitis
  • Gout
  • Posterior tibial tendonitis
  • Synovitis
  • Inflammation in the plantar fascia

Tarsal tunnel syndrome, which refers to tibial nerve compression in the ankle, and arthritis may present similar symptoms if you place weight on the ankle. These sensations include:

  • Intense pain
  • Tingling
  • Pricking
  • Burning

Arthritis in the ankle often develops in older individuals as well as athletes who have a history of ankle trauma.

Tendinitis and bursitis are similar conditions that are characterized by serious inflammation. Synovitis is described as inflammation in the lining of the joints. Gout is also an inflammatory arthritic condition. Each of these types of inflammation can be effectively treated with ankle injections.

Complementary approach 

For many, an ankle injection is not the end of your treatment. Risks with repeated injections are serious, and no more than three or four should be done a year.

Instead, these injections are a way for you to pursue other activities that can help treat the underlying cause of your pain. When approved by your doctor, use these in combination with physical therapy or other strengthening exercises.

Most patients who suffer from tarsal tunnel syndrome or arthritis report improved mobility and pain relief after receiving an ankle injection. They can help you get back to your life after ankle trauma or injury.


An ankle injection is a non-invasive procedure that involves injecting medication such as cortisone and lidocaine into the ankle joint. Cortisone is a corticosteroid that targets inflammation and lidocaine is a form of anesthesia that provides pain relief.  This treatment approach is typically suggested if you’ve already tried NSAIDs, extended rest, or physical therapy, but your symptoms haven’t improved.

Although possible complications may arise, this procedure is quite effective. Conditions that can be effectively treated with ankle injections include osteoarthritis, rheumatoid arthritis, tarsal tunnel syndrome, bursitis, gout, tendinitis, and synovitis. Most patients report enhanced mobility in addition to pain relief after receiving this type of injection.

You can find a pain doctor who specializes in these injections in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

Find Your Pain Doctor


References And Further Reading

  1. Cardone DA, Tallia AF. Joint and soft tissue injection. Am Fam Physician. 2002;66:283-288.
  2. Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the ankle and foot. Am Fam Physician. 2003;68(7):1356-1362.
  3. Khoury NJ, el-Khoury GY, Saltzman CL, Brandser EA. Intraarticular foot and ankle injections to identify source of pain before arthrodesis. AJR Am J Roentgenol. 1996;167:669–73.
  4. Omey ML, Micheli LJ. Foot and ankle problems in the young athlete. Med Sci Sports Exerc. 1999;31(7 suppl):S470-486.
  5. Stone DA, Abt JP, House AJ, Akins JS, Pederson JJ, Keenan KA, Lephart SM. Local anaesthetics use does not suppress muscle activity following an ankle injection. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1269-1278.
  6. https://www.ajronline.org/doi/full/10.2214/AJR.16.16243 
  7. https://www.ajronline.org/doi/abs/10.2214/AJR.12.9227
  8. https://www.aafp.org/afp/2003/1001/p1356.html