title: Effect of ice on pain after corticosteroid injection in the hand and wrist: a randomized controlled trial.
abstract: This prospective, randomized controlled study was designed to determine if applying ice to the site of corticosteroid injections in the hand and wrist reduces post-injection pain. Patients receiving corticosteroid injections in the hand or wrist at a tertiary institution were enrolled. Subjects were randomized to apply ice to the injection site and take scheduled over-the-counter analgesics ( n = 36) or take scheduled over-the-counter analgesics alone ( n = 32). There were no significant differences in the mean pain score between the two groups at any time-point (pre-injection or 1-5 days post-injection). In regression modelling, the application of ice did not predict pain after injection. Visual analogue pain scores increased at least 2 points (0-10 scale) after injection in 17 out of 36 patients in the ice group versus ten out of 32 control patients. We conclude that the application of ice in addition to over-the-counter analgesics does not reduce post-injection pain after corticosteroid injection in the hand or wrist.
  
  
  METHODS
  I Therapeutic Study.
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: T W
authors.initials: TW
authors.lastname: An
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Boone
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: M I
authors.initials: MI
authors.lastname: Boyer
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Gelberman
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Osei
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Calfee
mesh_terms: D000328:Adult; D000368:Aged; D017679:Cryotherapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006225:Hand; D006801:Humans; D007053:Ice; D007270:Injections, Intra-Articular / Q000009:adverse effects; D007592:Joint Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007053:Ice
keywords: Corticosteroid; flare reaction; ice; injection; pain