Injection Techniques for Common Chronic Pain Conditions of the Hand: A Comprehensive Review

Urits, Ivan; Smoots, Daniel; Anantuni, Lekha; Bandi, Prudhvi; Bring, Katie; Berger, Amnon A; Kassem, Hisham; Ngo, Anh L.; Abd‐Elsayed, Alaa; Manchikanti, Laxmaiah; Urman, Richard D.; Kaye, Alan D.; Viswanath, Omar

doi:10.1007/s40122-020-00158-4

Cited by 8 publications

(6 citation statements)

References 77 publications

(132 reference statements)

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“…One study in particular showed that triamcinolone injections compared to methylprednisolone had greater improvements in patient-reported pain and functionality. 46 In a randomized double-blind study, tenosynovitis remission in RA was achieved more frequently in the US-guided intratenosynovial CS injection group than in the intramuscular CS injection group. 68 In the study of Gray and colleagues, 43 reviewing the results of intratendon sheath CS injection in 173 episodes of flexor tenosynovitis in 46 RA patients, was found that 93% of the episodes resolved completely for 3 or more months (median: 25 months), the likelihood of a favorable response did not diminish with treatment of recurrent flexor tenosynovitis in a given digit and that tenosynovitis did not recur in 59% of cases.…”

Section: Current Evidence For Steroid Injectionmentioning

confidence: 97%

“…For stenosing tenosynovitis, single CS injection is considered to be the best method of care, and in the event of full reduction of symptoms and then recurrence, a second injection may be used. 46 , 47 Single local injection with triamcinolone acetonide is effective and safe for treating trigger finger and the effects of steroid injections last up to 12 months. 48 For trigger finger, in patients with partial improvement, optimal timing of the next injection appears to be after 69 days.…”

Section: Current Treatment Strategiesmentioning

confidence: 99%

“…One study in particular showed that triamcinolone injections compared to methylprednisolone had greater improvements in patient-reported pain and functionality. 46 …”

Section: Current Treatment Strategiesmentioning

confidence: 99%

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Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Carriero

Lubrano

Valentina

et al. 2021

Therapeutic Advances in Musculoskeletal

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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.

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Section: Current Evidence For Steroid Injectionmentioning

confidence: 97%

Section: Current Treatment Strategiesmentioning

confidence: 99%

See 1 more Smart Citation

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Carriero

Lubrano

Valentina

et al. 2021

Therapeutic Advances in Musculoskeletal

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“…Das Thema der lokalen Schmerztherapie umfasst sicher mehr als hier im Rahmen dieses Artikels darstellbar. Es sei auf entsprechende Übersichtsarbeiten zu diesem Thema verwiesen [97][98][99][100][101].…”

Section: Lokale Schmerztherapieunclassified

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

Pongratz

2020

Aktuelle Rheumatologie

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ZusammenfassungSchmerz als Hauptsymptom vieler chronisch-entzündlicher Erkrankungen stellt für den Patienten, aber auch für den behandelnden Arzt besonders in seiner chronifizierten Form eine große Herausforderung dar. Es gibt leider keine „Wunderpille“ mit der man Schmerzen für jeden gleich zuverlässig beseitigen kann. Es gibt aber viele Ansätze pharmakologischer als auch nicht-pharmakologischer Art und deren Kombination, um für den einzelnen Patienten wirksame Behandlungsstrategien zu finden. Um diese Strategien für jeden Patienten individuell optimal festzulegen, bedarf es zum einen eines fundamentierten Wissens über das Spektrum zur Verfügung stehender Mittel, zum anderen aber auch Erkenntnis darüber, wie diese sinnvoll nach Art der vorliegenden Schmerzformen einzusetzen sind. In dieser Übersicht wird beides behandelt, mit einem Fokus auf die medikamentöse Therapie von Schmerzen bei entzündlich-rheumatischen Erkrankungen. Dabei wird herausgearbeitet, dass es für die in diesem Zusammenhang relevantesten Formen des Schmerzes, akut-entzündlich nozizeptiv, neuropathisch und durch periphere und zentrale Sensibilisierung chronifizierte Schmerzen, jeweils andere wirksame Konzepte gibt.

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“…There are two conflicting hypotheses regarding the pathogenesis of CTS: one supports an edema-induced increase in carpal tunnel pressure, while another supports fibrosis of the subsynovial connective tissues in the carpal tunnel [3,4]. Although the optimal management of CTS is still controversial, there is strong evidence for the efficacy of local steroid injection (LSI) [5][6][7]. The therapeutic rationale of LSI is the ability to reduce edema, allowing more space around the carpal tunnel and the median nerve and tendons [8,9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Distal and Proximal Local Steroid Injection for Carpal Tunnel Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2022

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Introduction: Local steroid injection (LSI) in the carpal tunnel is a mainstay of conservative treatment in patients with carpal tunnel syndrome (CTS). Currently, clinicians generally perform a conventional proximal approach (PA) or novel distal approach (DA) for LSI. Recent systematic reviews comparing the two injection methods are lacking. This systematic review and meta-analysis aimed to assess whether LSI using the DA was superior to PA in treating patients with CTS. Methods: Databases including Pubmed, Embase, and the Cochrane library were searched up to 30 May 2022 to identify relevant randomized controlled trials (RCTs) comparing the DA with the PA steroid injection in patients with CTS. The outcomes mainly included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQs) and Functional Status Scale (BCTQf), visual analog scores (VAS), electrophysiological outcomes, pain of injection, duration of injection, or adverse events. Results: Five RCTs involving 339 patients were identified. Pooled analysis showed that the DA group took less time [mean difference (MD) -19.91; 95% CI -34.48 to -5.35; P = 0.007] and acquired better sensory nerve action potential amplitude [standardized mean difference (SMD) -0.37; 95% CI -0.62 to -0.11; P = 0.005]. The two groups were not significantly different in terms of BCTQs and BCTQf, VAS, other electrophysiological outcomes, pain of injection, or adverse events (P [ 0.05). Chunke Dong and Yuting Zhu contributed equally to this study and should be considered co-first authors.

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Injection Techniques for Common Chronic Pain Conditions of the Hand: A Comprehensive Review

Cited by 8 publications

References 77 publications

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

Comparison of Distal and Proximal Local Steroid Injection for Carpal Tunnel Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials

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