Steroid versus placebo injection for trigger finger

Use of QVAR with a spacer device in children less than 5 years of age is not recommended. In vitro dose characterization studies were performed with QVAR 40 mcg/actuation with the OptiChamber and AeroChamber Plus ® spacer utilizing inspiratory flows representative of children under 5 years old. These studies indicated that the amount of medication delivered through the spacing device decreased rapidly with increasing wait times of 5 to 10 seconds as shown in Table 2. If QVAR is used with a spacer device, it is important to inhale immediately.

When considering the results for the individual symptoms, benefit was shown in the intranasal corticosteroids group. The effect size was larger for nasal blockage ( MD -, 95% CI - to -; 1702 participants; six studies) than for rhinorrhoea ( MD -, 95% CI - to -; 1702 participants; six studies) or loss of sense of smell ( MD -, 95% CI - to -; 1345 participants; four studies). There was heterogeneity in the analysis for facial pain/pressure ( MD -, 95% CI - to ; 243 participants; two studies). The quality of the evidence was moderate for nasal blockage, rhinorrhoea and loss of sense of smell, but low for facial pain/pressure.

The ability of a single injection of steroid and lidocaine to bring about cure of primary trigger finger was determined and compared with a control placebo injection of only lidocaine. Twenty-four patients were randomized to the therapeutic or control group and were followed prospectively. One physician administered the injection, another the clinical examination after injection, and a third evaluated the results blindly. Patients were not told to which group they were assigned. Nine of the 14 patients in the steroid group versus two of the ten patients in the placebo group were cured of trigger finger at final follow-up examination. After injection, seven patients had immediate but temporary relief of triggering because of flexor sheath distention. One injection cured 16 of patients with primary trigger finger with no side effect and is the recommended nonsurgical treatment.

Steroid injections are commonly used to treat rotator cuff tendinopathy, but controlled studies have demonstrated modest benefit, particularly in the long term. 34 Steroid injections should be reserved for patients who have discomfort that would limit them from engaging in rehabilitative exercises. Injections into the gluteal muscle versus guided injections into the subacromial bursa have demonstrated similar levels of pain relief. 35 Surgical options are available for patients with persistent symptoms, or for patients in whom function cannot be maintained.

Steroid versus placebo injection for trigger finger

steroid versus placebo injection for trigger finger

Steroid injections are commonly used to treat rotator cuff tendinopathy, but controlled studies have demonstrated modest benefit, particularly in the long term. 34 Steroid injections should be reserved for patients who have discomfort that would limit them from engaging in rehabilitative exercises. Injections into the gluteal muscle versus guided injections into the subacromial bursa have demonstrated similar levels of pain relief. 35 Surgical options are available for patients with persistent symptoms, or for patients in whom function cannot be maintained.

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