Injections are valuable procedures for managing musculoskeletal
conditions commonly encountered by family physicians. Corticosteroid
injections into articular, periarticular, or soft tissue structures
relieve pain, reduce inflammation, and improve mobility. Injections can
provide diagnostic information and are commonly used for postoperative
pain control. Local anesthetics may be injected with corticosteroids to
provide additional, rapid pain relief. Steroid injection is the
preferred and definitive treatment for de Quervain tenosynovitis and
trochanteric bursitis. Steroid injections can also be helpful in
controlling pain during physical rehabilitation from rotator cuff
syndrome and lateral epicondylitis. Intra-articular steroid injection
provides pain relief in rheumatoid arthritis and osteoarthritis. There
is little systematic evidence to guide medication selection for
therapeutic injections. The medication used and the frequency of
injection should be guided by the goal of the injection (i.e.,
diagnostic or therapeutic), the underlying musculoskeletal diagnosis,
and clinical experience. Complications from steroid injections are rare,
but physicians should understand the potential risks and counsel
patients appropriately. Patients with diabetes who receive periarticular
or soft tissue steroid injections should closely monitor their blood
glucose for two weeks following injection.
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Am Fam Physician. 2008 Oct 15;78(8):971-976.
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