title: Evaluating short-term pain after steroid injection.
abstract: Steroids are injected into joints for various indications. All steroid preparations relieve pain similarly over the long term. Therefore, decisions about which preparation to use are often arbitrary. We evaluated methylprednisolone acetate and a combination of betamethasone diproprionate and betamethasone sodium phosphate for short-term pain and the predictive value of short-term pain. Eighty-five patients were injected in prospective double-blind randomized fashion. Pain was evaluated by visual analog scale (1 = no pain, 10 = severe pain) at baseline, 3 days, and 3 weeks. No patient had joint pain immediately after injection. Three days after injection, mean (SD) pain levels were 5.1 (2.9) for methylprednisolone and 5.2 (2.6) for betamethasone (P = .97); 3 weeks after injection, they were 4.0 (2.8) and 3.7 (2.5), respectively (P = .57). Short-term pain increased from baseline for both preparations and decreased from 3 days to 3 weeks. Pain at 3 days and 3 weeks was positively correlated. This study does not support a difference in short-term pain between preparations. The significant correlation between short- and long-term pain may justify early decisions regarding treatment, especially in patients with high levels of initial pain.
authors.affiliation: Connecticut Combined Hand Surgery, Hartford Hospital, University of Connecticut School of Medicine, USA. wollst1@verizon.net
authors.forename: Ronit
authors.initials: R
authors.lastname: Wollstein
authors.forename: Gershon
authors.initials: G
authors.lastname: Chaimsky
authors.forename: Lois
authors.initials: L
authors.lastname: Carlson
authors.forename: H K
authors.initials: HK
authors.lastname: Watson
authors.forename: Gadi
authors.initials: G
authors.lastname: Wollstein
authors.forename: Jaber
authors.initials: J
authors.lastname: Saleh
mesh_terms: D000368:Aged; D001623:Betamethasone / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D020069:Shoulder Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013585:Synovitis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone; D008775:Methylprednisolone