Intra-Articular Steroid Injection for Pain Relief in Osteoarthritis of the Hip

2001 ◽  
Vol 23 (3) ◽  
pp. 113-115 ◽  
Author(s):  
M.A. Wajid ◽  
R. Kumar ◽  
M.R.S. C M E Lennox
Keyword(s):  
Pain Relief ◽  
Steroid Injection ◽  
Osteoarthritis Of The Hip

Comparative Efficacy and Patient- Specific Moderating Factors of Nonsurgical Treatment Strategies for Frozen Shoulder: An Updated Systematic Review and Network Meta-analysis

2020 ◽  
pp. 036354652095629
Author(s):  
Jie Zhang ◽  
Shuchang Zhong ◽  
Tongcai Tan ◽  
Juebao Li ◽  
Shuang Liu ◽  
...  
Keyword(s):  
Pain Relief ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Frozen Shoulder ◽  
Shoulder Function ◽  
Functional Improvement ◽  
Patient Specific ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Moderating Factors

Background: Frozen shoulder is a common shoulder disorder characterized by pain and restriction. Various nonsurgical treatments have been reported, but there is no consensus about their comparative efficacy and the effects of moderators. Purpose: To compare the efficacy of different nonsurgical interventions and identify potential patient-specific moderating factors for frozen shoulder. Study Design: Systematic review and network meta-analysis. Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched from their inception to February 18, 2019. The search was supplemented by manual review of relevant reference lists. Randomized controlled trials of participants with frozen shoulder that compared nonsurgical interventions were selected. Measured outcomes included pain, shoulder function in daily activities, and range of motion. Results: Of 3136 records identified, 92 trials were eligible, evaluating 32 nonsurgical interventions in 5946 patients. Intra-articular injection improved pain (pooled standardized mean difference [95% CI]: steroid injection, 1.68 [1.03-2.34]; capsular distension, 2.68 [1.32-4.05]) and shoulder function (steroid injection, 2.16 [1.52-2.81]; distension, 2.89 [1.71-4.06]) to a greater extent than placebo. Capsular distension and extracorporeal shockwave therapy showed the highest ranking for pain relief and functional improvement, respectively. Laser therapy also showed benefits for pain relief (3.02 [1.84-4.20]) and functional improvement (3.66 [1.65-5.67]). Subgroup analyses by disease stages revealed that steroid injection combined with physical therapy provided more benefits during the freezing phase, whereas joint manipulation provided more benefits in the adhesive phase. Adjunctive therapies, female sex, and diabetes were also identified as moderators of effectiveness. Conclusion: Capsular distension is a highly recommended choice for treatment of frozen shoulder, contributing greatly to pain relief and functional improvement; steroid injection is also a prevailing effective intervention. Among new options, extracorporeal shockwave therapy and laser therapy show potential benefits for multiple outcomes. Individualized optimal intervention should be considered, given that treatment effect is moderated by factors including the disease stage, time of assessment, adjunctive therapies, female sex, and diabetes.

scholarly journals Patient-Reported Outcomes and Satisfaction after Cervical Epidural Steroid Injection for Cervical Radiculopathy

2019 ◽  
Vol 8 ◽  
Author(s):  
Masoud Hashemi ◽  
Payman Dadkhah ◽  
Mehrdad Taheri ◽  
Mahshid Ghasemi ◽  
Ali Hosseinpoor ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Patient Reported Outcomes ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Patient Reported ◽  
The Mean ◽  
Epidural Steroid

Background: Cervical radiculopathy caused by disc herniation is a frequent public health issue with economical and socio-professional impacts. The objective of the present study is to evaluate the patient-reported outcomes and satisfaction from cervical epidural steroid injection during a 2-year follow-up. Materials and Methods: Results based on patients’ reports from a previously performed intervention of cervical epidural steroid injection on patients with cervical radiculopathy due to cervical disc herniation are prospectively collected. Outcome measures are Neck Disability Index (NDI), numerical rating scale (NRS) for pain assessment, and 5-scale patient satisfaction questionnaire (PSQ) plus opioid medication for pain relief, additional injections, and progression to surgery. Results: Of total 37 cases, 34 were available for follow-up after 2-year postoperatively. The mean preoperative NDI was 21.17 and improved to 17.38, and the mean NRS was 7.7 and improved to 5.00; both were statistically significant. Mean patient satisfaction after 2 years was 3.17 out of 5. 11 cases needed additional injections, and 4 of patients proceeded to surgery. Conclusion: We showed that transforaminal cervical epidural steroid injection for cervical radiculopathy is an effective non-surgical treatment option, providing significant pain relief and functional improvement during 2-years follow-up along with higher-than-average patient satisfaction in most of our patients. [GMJ.2019;8:e1478]

scholarly journals Heel lifting as a conservative therapy for osteoarthritis of the hip: Based on the rationale of Pauwels' intertrochanteric osteotomy

1997 ◽  
Vol 21 (2) ◽  
pp. 153-158 ◽  
Author(s):  
S. Ohsawa ◽  
R. Ueno
Keyword(s):  
Pain Relief ◽  
Hip Joint ◽  
Conservative Therapy ◽  
Palliative Therapy ◽  
Pelvic Obliquity ◽  
Intertrochanteric Osteotomy ◽  
Osteoarthritis Of The Hip ◽  
Relieve Pain ◽  
Time Required

Patients with osteoarthritis of the hip were treated with a conservative therapy of heel lifting. Orthoses were applied on 35 hips in 33 subjects and the cases were followed for 23 months on average. Dramatic pain relief was reported, but the time required to reduce or completely relieve pain increased according to the stage of osteoarthritis. The radiological results were not satisfactory. During the follow-up, only two hips showed improvement, 22 showed no change, and 11 deteriorated. The mechanism of heel lifting in relation to the hip joint was analysed, showing that pelvic obliquity was achieved and the trunk stabilized. In conclusion this simple orthosis was effective as a palliative therapy for osteoarthritis of the hip.

The period of pain relief following a successful epidural steroid injection for low-back pain

2002 ◽  
Vol 13 (4) ◽  
pp. 331-338 ◽  
Author(s):  
Henk M. Koning ◽  
Alex J. Koning ◽  
Tobias C. M. Bruinen ◽  
Hans G. Koster ◽  
Evert Heybroek
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Epidural Steroid

scholarly journals Concordant Pain Provocation During Transforaminal Epidural Steroid Injection for Lumbosacral Radiculopathy: Effect on Pain Outcome and Predictive Factors

2015 ◽  
Vol 18;1 (1;1) ◽  
pp. E19-E26
Author(s):  
Zack McCormick
Keyword(s):  
Pain Relief ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Foraminal Stenosis ◽  
Short Term ◽  
Pain Provocation ◽  
Pain Outcomes ◽  
Epidural Steroid

Background: Anecdotal report suggests that provocation of pain during epidural steroid injection (ESI) that is concordant with typical radicular symptoms predicts pain outcome following injection. However, limited evidence exists that substantiates this theory. Additionally, there is a paucity of literature investigating factors associated with the provocation of pain during ESI. Objectives: The goal of this study was to determine whether provocation of concordant radicular pain during transforaminal ESI predicts pain relief immediately after injection and at short-term follow-up. Demographic, radiologic, and procedural factors associated with the pain provocation and pain outcomes at immediate and short-term follow-up were also investigated. Study Design: Longitudinal cohort study. Setting: Urban academic outpatient interventional spine clinics. Methods: Adults who underwent a fluoroscopically guided transforaminal ESI without sedation between January 1, 2006, and October 29, 2007, for the treatment of lumbosacral radicular pain were included in this study. The relationships between provocation of concordant pain, immediate post-injection, and follow-up visual analogue scale (VAS) pain scores, as well as with demographic, radiologic, and procedural factors were determined using chi-square/Fisher’s exact tests for categorical variables and t-tests or ANOVA for numerical variables. Results: One thousand twenty one patients, 42.4% (433) male/57.6% (588) female, with a mean (SD) age of 54.1 (16.7) years were included in the study. Concordant pain provocation did not predict the magnitude of pain reduction (P = 0.9255) or the frequency of achieving > 50% pain relief (P = 0.7449) at short-term follow-up. Radiologic evidence of foraminal stenosis or nerve root impingement (P < 0.0001) and the lack of a medial-superior contrast flow pattern (P = 0.0199) were associated with a greater frequency of pain provocation during transforaminal ESI. Limitations: This study is primarily limited by possible selection bias given that patients who did not follow-up in the clinic could not be studied, and an incomplete follow-up rate (66%). Conclusions regarding subacute and long-term pain outcomes cannot be determined from this study as only short-term data were available. Conclusions: Provocation of concordant radicular pain does not predict pain relief at short-term follow-up after a transforaminal ESI. Foraminal stenosis, nerve root impingement, and lack of a medial-superior contrast flow pattern are associated with pain during the transforaminal ESI. Thus, clinicians should be aware of these radiologic and procedural risk factors for inciting pain during transforaminal ESI. Key words: Epidural steroid injection, lumbar, radicular pain, outcomes, prognostic

High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis

2013 ◽  
Vol 39 (8) ◽  
pp. 838-844 ◽  
Author(s):  
T. H. Low ◽  
P. F. Hales
Keyword(s):  
Pain Relief ◽  
Steroid Injection ◽  
Revision Operation ◽  
Thumb Carpometacarpal Joint ◽  
Flexor Carpi Radialis ◽  
Abductor Pollicis Longus ◽  
High Incidence ◽  
Good Pain Relief ◽  
Thumb Carpometacarpal ◽  
Joint Arthritis

We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2–10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

scholarly journals CT-guided transforaminal epidural steroid injection for discogenic lumbar radiculopathy: influence of contrast dispersion and radiologist’s experience on clinical outcome

2021 ◽  
Author(s):  
Christoph Germann ◽  
Dimitri N. Graf ◽  
Benjamin Fritz ◽  
Reto Sutter
Keyword(s):  
Pain Relief ◽  
Steroid Injection ◽  
Pain Reduction ◽  
Therapeutic Outcome ◽  
Epidural Steroid Injection ◽  
Dispersion Pattern ◽  
Ct Guided ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid ◽  
The Impact

Abstract Objective To investigate the impact of contrast dispersion pattern/location during lumbar CT-guided transforaminal epidural steroid injection (TFESI) and experience of the performing radiologist on therapeutic outcome. Materials and methods In this single-center retrospective cohort study, two observers analyzed contrast dispersion during CT-guided TFESI of 204 patients (age 61.1 ± 14 years) with discogenic unilateral single-level L4 or L5 radiculopathy. The contrast dispersion pattern was classified as “focal,” “linear,” or “tram-track”; the location was divided into “extraforaminal,” “foraminal,” or “recessal.” Pain was assessed before and 4 weeks after treatment using a numerical rating scale (0, no pain; 10, intolerable pain). Additionally, the patient global impression of change (PGIC) was assessed. The TFESI was performed by musculoskeletal radiologists (experience range: first year of musculoskeletal fellowship training to 19 years). Contrast pattern/location and radiologist’s experience were compared between “good responder” (≥ 50% pain reduction) and “poor responder” (< 50%). A p-value < 0.05 was considered to be statistically significant. Results Overall, CT-guided TFESI resulted in a substantial pain reduction in 46.6% of patients with discogenic radiculopathy. The contrast dispersion pattern and location had no effect on pain relief (p = 0.75 and p = 0.09) and PGIC (p = 0.70 and p = 0.21) 4 weeks after TFESI. Additionally, the experience of the radiologist had no influence on pain reduction (p = 0.92) or PGIC (p = 0.75). Regarding pre-interventional imaging findings, both the location and grading of nerve compression had no effect on pain relief (p = 0.91 and p = 0.85) and PGIC (p = 0.18 and p = 0.31). Conclusion Our results indicate that neither contrast agent dispersion/location nor the experience of the radiologist allows predicting the therapeutic outcome 4 weeks after the procedure.

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