PURPOSE: Some patients report a transient increase in pain the day after a corticosteroid injection. We investigated factors associated with greater pain during and the day after a corticosteroid injection for idiopathic trigger finger. METHODS: A total of 100 patients with trigger finger completed questionnaires measuring heightened illness concern, catastrophic thinking, depression, perceived health, expected pain, pain with injection, and pain the day after injection. We performed bivariate analysis to determine variables associated with pain with injection, next-day pain, and next-day pain greater than 4 points on an 11-point ordinal scale. We entered variables with a significant correlation into multivariable linear regression models. RESULTS: The average pain with injection and the day after injection were 4.3 (SD 2.8) and 1.8 (SD 2.0), respectively. Expected pain, heightened illness concern, catastrophic thinking, depression, physician, and gender correlated with pain with injection. A multivariable regression model conducted in backward stepwise fashion demonstrated that physician, depression, expected pain, and female gender explained 28% of the variance in pain with injection. Pain with injection was the only significant predictor of next-day pain and pain greater than 4 points the day after injection. CONCLUSIONS: Our data suggest that psychosocial factors are the strongest correlates of pain with corticosteroid injection, but a large portion of the variability remains unexplained. Future research will investigate cognitive/behavioral methods for decreasing pain with injection. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic I.
PURPOSE: Some patients report a transient increase in pain the day after a corticosteroid injection. We investigated factors associated with greater pain during and the day after a corticosteroid injection for idiopathic trigger finger. METHODS: A total of 100 patients with trigger finger completed questionnaires measuring heightened illness concern, catastrophic thinking, depression, perceived health, expected pain, pain with injection, and pain the day after injection. We performed bivariate analysis to determine variables associated with pain with injection, next-day pain, and next-day pain greater than 4 points on an 11-point ordinal scale. We entered variables with a significant correlation into multivariable linear regression models. RESULTS: The average pain with injection and the day after injection were 4.3 (SD 2.8) and 1.8 (SD 2.0), respectively. Expected pain, heightened illness concern, catastrophic thinking, depression, physician, and gender correlated with pain with injection. A multivariable regression model conducted in backward stepwise fashion demonstrated that physician, depression, expected pain, and female gender explained 28% of the variance in pain with injection. Pain with injection was the only significant predictor of next-day pain and pain greater than 4 points the day after injection. CONCLUSIONS: Our data suggest that psychosocial factors are the strongest correlates of pain with corticosteroid injection, but a large portion of the variability remains unexplained. Future research will investigate cognitive/behavioral methods for decreasing pain with injection. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic I.
Authors: Nikolas H Kazmers; Angela P Presson; Ziji Yu; Wyatt Walsh; Douglas T Hutchinson; Andrew R Tyser Journal: J Hand Surg Am Date: 2020-07-05 Impact factor: 2.230
Authors: Nikolas H Kazmers; Man Hung; Ajinkya A Rane; Jerry Bounsanga; Cindy Weng; Andrew R Tyser Journal: J Hand Surg Am Date: 2017-09-09 Impact factor: 2.230
Authors: Anuj Bhatia; Vera Bril; Richard T Brull; Anthony V Perruccio; Duminda N Wijeysundera; Johnny Lau; Rajiv Gandhi; Nizar Mahomed; Aileen M Davis Journal: Pain Rep Date: 2021-07-13