but do you think injecting tennis elbow is a waste of time? I suspect most of us didn't but the recent trials show that watchful waiting has a better outcome...good trials, done by community rheumatologist / primary care people who know how to do studies. 
calcaneal spurs are the result of the pathology rather than the cause...sorry to be pedantic! There is a 3rd alternative to your possibilities: 1) it works 2) it hurts so they don't come back 3) it co-incidentally gets better and the patient may or may not attribute recovery to your highly skilled injection. My vote probably goes to 3 for many. There is however a study showing that ultrasound guided plantar fasciitis injection is more successful than clinical injection, so there's probably some kind of therapeutic effect. 
definitely not doubting the GP's eye though - I struggle enough with my filtered caseload...
Lesley

On 23 Apr 2007, at 20:38, Paul Bromley wrote:


Now, what we need to do is persuade the powers that be that A GP's eye, and
opinion on clinical diagnosis, are valuable.

As we all know, Primary Care is far different than secondary care, and
it often seems odd what consultants pontificate about at times. They
have to remember that they are seeing the 'tip of the iceberg'. I went
to a meeting recently where the orthopaedic surgeon said that
injecting calcaneal spurs was a waste of time. Seems that we have been
wasting a lot of time. I rarely see them again, so it either works or
they are too fearful of a further injection. I suspect the former.
Also a bit like the ophthalmologists who say that unilateral red eye
is rarely conjunctivitis - not here in Cheshire & Staffs!

Paul Bromley