Does Anesthetic Relief Correspond to Future Pain Relief?: A Prospective Trial Examining Future Pain Relief for Ultrasound-Guided Corticosteroid-Anesthetic Injections.
Daniel M Cushman, Jordan Knox, Jacqueline K Kobayashi and 5 others
PMID 35019871WHAT IT FOUND
Immediate pain relief from the anesthetic in a steroid injection poorly predicts long-term benefit.
Patients without immediate relief still had a 50% chance of improvement by three months. Most patients report steroid relief within four days, though it can take up to two weeks.
Key findings
01Patients who did not experience immediate pain relief from the anesthetic still had a 50% chance of achieving at least 50% pain relief by three months.
02Approximately 80% of patients reported pain relief from the corticosteroid component within four days, though some took over a week.
03No demographic or procedural factors, such as age, gender, or injection type, were significantly associated with the time to pain relief or the likelihood of long-term response.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relied on patient recall for the exact timing of pain relief, which was assessed at two weeks rather than daily. Concurrent treatments such as physical therapy and pain medications were not controlled for, which may have influenced pain scores. Psychosocial factors known to affect pain perception, such as anxiety and fear-avoidance, were not measured. Physicians chose the specific anesthetic and corticosteroid agents and doses, introducing variability in the interventions.
Declared interests
The authors report no competing interests.
The easy way to misread this
Do not assume that a patient who experiences no immediate pain relief from the anesthetic portion of the injection will fail to benefit from the corticosteroid. The study showed that 50% of these initial non-responders still achieved significant pain relief by three months.