Corticosteroid Injection Practices of Australian Podiatrists for Common Foot and Ankle Conditions.

INTRODUCTION

Corticosteroid injections are commonly used to manage foot and ankle conditions; however, there is limited evidence guiding corticosteroid selection, dosing, imaging guidance and injection techniques. This study aimed to describe current corticosteroid injection practices among Australian podiatrists and podiatric surgeons.

METHODS

A descriptive cross-sectional survey was distributed via REDCap to Australian podiatrists and podiatric surgeons endorsed to prescribe scheduled medicines. The questions were developed using an iterative process and focused on demographic and professional characteristics, administrative factors and injection practices for plantar fascia, intermetatarsal and intra-articular injections. The survey was conducted between January 2025 and April 2026 and reported according to the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Descriptive statistics were used to summarise injection practices for plantar fascia, intermetatarsal and intra-articular injections.

RESULTS

Forty-five people participated in the study, and 33 completed the survey in full. Participants had a mean of 17.1 years in practice and 9.6 years administering corticosteroid injections. Most participants were endorsed podiatrists (64%), with the remainder being podiatric surgeons (33%). Participants reported administering a mean maximum of three corticosteroid injections per patient annually and recommending a mean interval of 3 months between injections. Betamethasone 5.7 mg/mL was the most common corticosteroid across all injection sites and was frequently combined with ropivacaine or bupivacaine. Ultrasound guidance was used by 50% of participants for plantar fascia injections, 39% for intermetatarsal injections and 46% for intra-articular injections. Symptom relief was perceived to last between 3 and 6 months, whereas adverse effects were recalled to be infrequent and most commonly included steroid flare and post-injection pain.

CONCLUSION

Australian podiatrists and podiatric surgeons reported consistency in some corticosteroid injection practices and variability in others. These findings provide an initial descriptive benchmark of corticosteroid injection practice in Australian podiatry and may inform future clinical guidelines and research.