A Systematic Review of the Efficacy of Corticosteroid Injections of Tendon Sheaths, Excluding Stenosing Tenosynovitis of the Wrist and Hand

Cushman, Daniel M; Carefoot, Andrea; Lisenby, Suzan; Caragea, Marc; Fogg, Benjamin; Conger, Aaron

doi:10.1097/phm.0000000000001609

Cited by 3 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…

Corticosteroid injections have demonstrated pain relief in the treatment of a multitude of musculoskeletal pathologies, such as osteoarthritis, tendinopathy, trigger finger, tenosynovitis, and adhesive capsulitis. [4][5][6] Given the ubiquity of corticosteroid injections in modern musculoskeletal practice 18 within the realm of musculoskeletal medicine, it naturally follows that a variety of side effects have been reported. 21 Prior studies have examined the incidence, intensity, and quality of these side effects.

…”

mentioning

confidence: 99%

Prospective Evaluation of Pain Flares and Time Until Pain Relief Following Musculoskeletal Corticosteroid Injections

Cushman¹,

Kobayashi²,

Wheelwright³

et al. 2022

Sports Health: A Multidisciplinary Approach

Self Cite

View full text Add to dashboard Cite

Background: Corticosteroid injections are used ubiquitously within musculoskeletal medicine. One of the most common side effects is a postinjection pain flare, though little is known regarding this phenomenon. Hypothesis: Some risk factors are related to postinjection pain flare following an ultrasound-guided corticosteroid injection. Study Design: Prospective clinical research study. Level of Evidence: Level 2. Methods: Patients undergoing ultrasound-guided corticosteroid injections in an academic orthopaedic and sports medicine clinic were approached to participate. Patients completed a survey immediately following their injection and again 2 weeks later, asking them about their pain and side effects. A postinjection pain flare was defined as an increase in pain, as defined by the patient. Results: A total of 140 patients completed the entirety of the study, with 29 (20.7%) patients reporting a flare of pain. There was a significant effect of younger age on the development of a pain flare after the injection, estimated as 5.5% decreased odds of developing a flare per year of age ( P < 0.01). Gender, injection location, body mass index (BMI), preinjection pain, and corticosteroid type had no contributing effect. When patients obtained relief following the corticosteroid injection, 60.4% had improved pain within 3 days, whereas over 93.7% obtained relief within a week. Conclusion: Pain flares seem to affect approximately 1 in 5 patients. With increasing age, the likelihood of postinjection pain flare becomes less likely. Sex, injection location, BMI, preinjection pain, and corticosteroid type do not seem to significantly relate to an increase in pain following injection. Clinical Relevance: Corticosteroid injections are common procedures in the orthopaedic and sports medicine settings. Younger patients can be counseled on the higher likelihood of a pain flare following a corticosteroid injection.

show abstract

“…

…”

mentioning

confidence: 99%

Prospective Evaluation of Pain Flares and Time Until Pain Relief Following Musculoskeletal Corticosteroid Injections

Cushman¹,

Kobayashi²,

Wheelwright³

et al. 2022

Sports Health: A Multidisciplinary Approach

Self Cite

View full text Add to dashboard Cite

show abstract

“…31 Thus, corticosteroid pain relief generally takes longer to begin, with the duration of pain relief measured in months. [5][6][7]12 The design of this study could not discern any factors associated with faster or slower relief. This study demonstrates that most subjects will obtain pain relief within a few days on average but can take up to 2 wks (or possibly even longer, which we did not record).…”

Section: Time Until Relief From Corticosteroid Injectionmentioning

confidence: 91%

“…4 Literature suggests that corticosteroid injections to joints and tendon sheaths have mild to moderate benefit in treating pain, generally lasting in the order of weeks to months. 2,[5][6][7] There is a paucity of research on the immediate effects of anesthetic injection with longer-term pain relief from corticosteroid injections, particularly in the field of hip pathology 8,9 and sacroiliac (SI) joint pain. 10 A 2016 systematic review of IA injections to the hip included seven studies, all of which demonstrated pain relief immediately after anesthetic injection, and three studies reporting pain relief 2 wks after injection.…”

mentioning

confidence: 99%

Does Anesthetic Relief Correspond to Future Pain Relief?

Cushman

Knox²,

Kobayashi³

et al. 2022

Am J Phys Med Rehabil

Self Cite

View full text Add to dashboard Cite

Objectives: The aim of the study was to prospectively evaluate the association between immediate pain relief from injections of local anesthetic with corticosteroid and subsequent pain relief up to 3 mos. The secondary aim was to examine the time until subjective pain relief after these injections. Design: This was a single-center, prospective study of patients undergoing ultrasound-guided corticosteroid injections for musculoskeletal pain. Subjects completed follow-up surveys at 2 wks, 1 mo, and 3 mos postinjections. χ 2 tests and sensitivity analysis were used to examine the primary outcome, at least 50% relief from the injection. Regression modeling examined the effects of demographic and injection-related variables on outcome measures. Results: A total of 132 patients were enrolled (55% female, mean age 52 yrs). Response rates were 87.1% at 2 wks and 77.2% at 3 mos. The positive likelihood ratios from 50% initial pain relief ranged from 1.22 to 1.29 at the three time points, whereas the negative likelihood ratios ranged from 0.54 to 0.63. More than 75% of participants reported subjective pain relief by day 4 after injection. Conclusions: The predictive value of immediate pain relief for subsequent longer-term pain relief from corticosteroid-anesthetic injections is not particularly high. Most patients will obtain pain relief within 4 days of a corticosteroid injection.

show abstract

“…A systematic review of the efficacy of CS injections of tendon sheaths, excluding stenosing tenosynovitis of the wrist and hand, found that low-quality studies suggest that tendon sheath injections may provide at least short-term improvement in pain. 65 …”

Section: Current Treatment Strategiesmentioning

confidence: 99%

“…64 A systematic review of the efficacy of CS injections of tendon sheaths, excluding stenosing tenosynovitis of the wrist and hand, found that low-quality studies suggest that tendon sheath injections may provide at least short-term improvement in pain. 65 In a model to estimate the costs and outcomes associated with treatment strategies for trigger finger was found that offering 3 CS injections before surgery is a cost-effective strategy. The results were sensitive to the probability of injection site fat necrosis, success rate of steroid injections, time to symptom relief after a steroid injection, and cost of treatment.…”

Section: Current Evidence For Steroid Injectionmentioning

confidence: 99%

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Carriero

Lubrano

Valentina

et al. 2021

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

Dactylitis – a hallmark clinical feature of psoriatic arthritis (PsA) – that occurs in 30–50% of PsA patients, is a marker of disease severity for PsA progression, an independent predictor of cardiovascular morbidity and impairs the motor functions of PsA patients. There is a paucity of evidence for the treatment due to the absence of randomized controlled trials assessing dactylitis as a primary endpoint and current practice arises from the analysis of dactylitis as a secondary outcome. Corticosteroid (CS) injections for dactylitis in PsA patients are a therapeutic treatment option for patients with isolated dactylitis or for patients with flares in tendon sheaths, despite stable and effective systemic treatment. The aim of this narrative review is to briefly illustrate the clinical aspects of dactylitis in PsA, the imaging and clinimetric tools used to diagnose and monitor dactylitis, the current treatment strategies and principally to provide a comprehensive picture of the clinical efficacy and safety with ultrasound-guide and blind techniques of CS injections for dactylitis in PsA patients.

show abstract

A Systematic Review of the Efficacy of Corticosteroid Injections of Tendon Sheaths, Excluding Stenosing Tenosynovitis of the Wrist and Hand

Cited by 3 publications

References 19 publications

Prospective Evaluation of Pain Flares and Time Until Pain Relief Following Musculoskeletal Corticosteroid Injections

Prospective Evaluation of Pain Flares and Time Until Pain Relief Following Musculoskeletal Corticosteroid Injections

Does Anesthetic Relief Correspond to Future Pain Relief?

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Contact Info

Product

Resources

About