title: Disability and pain after cortisone versus placebo injection for trapeziometacarpal arthrosis and de Quervain syndrome.
abstract: BACKGROUND
  This study tested the null hypothesis that type of injection (corticosteroid vs. placebo) is not a predictor of arm-specific disability as measured with the Disabilities of Arm, Shoulder and Hand questionnaire 1 to 3 months after injection of dexamethasone or placebo for treatment of trapeziometacarpal (TMC) arthrosis or de Quervain syndrome. Secondly, we tested if type of injection was a predictor of pain intensity.
  
  
  METHODS
  Thirty-six English-speaking adults with TMC arthrosis or de Quervain syndrome were randomized for a dexamethasone or a placebo injection. At time of the injection, patients completed a demographic data sheet and validated questionnaires assessing arm-specific disability, pain intensity, depressive symptoms, pain catastrophizing, and patient's health-related beliefs. At an average of 1.4 ± 0.42 months (range, 0.79-2.5 months) after the injection, patients completed questionnaires regarding arm-specific disability, pain, and treatment satisfaction. Grip and pinch strength measurements were measured at both time points. Bivariable and multivariable analyses assessed predictors of arm-specific disability and pain intensity at follow-up.
  
  
  RESULTS
  Type of injection was not a predictor of arm-specific disability or pain intensity 1 to 3 months after injection. The best model both for arm-specific disability and pain intensity at follow-up included pain catastrophizing and explained 18 % and 33 % of the variability, respectively.
  
  
  CONCLUSIONS
  Catastrophic thinking was a better predictor of both of arm-specific disability and pain intensity than diagnosis or type of injection (steroid vs. placebo) 1to 3 months after an injection.
authors.affiliation: MGH Hand Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Dennis J S
authors.initials: DJ
authors.lastname: Makarawung
authors.affiliation: MGH Hand Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Stéphanie J E
authors.initials: SJ
authors.lastname: Becker
authors.affiliation: MGH Hand Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Stijn
authors.initials: S
authors.lastname: Bekkers
authors.affiliation: MGH Hand Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Arm-specific disability; Corticosteroid injection; De Quervain syndrome; Pain; Trapeziometacarpal arthrosis