• Abhishek Julka, Ana-Maria Vranceanu, Apurva S Shah, Frank Peters, and David Ring.
• Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
• J Hand Surg Am. 2012 Feb 1;37(2):237-42.

PurposeSome 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.MethodsA 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.ResultsThe 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.ConclusionsOur 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 EvidencePrognostic I.Copyright © 2012 American Society for Surgery of the Hand. All rights reserved.

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