Review of Steroid-only Injection Therapy Clinics Performed by a Physiotherapist Working in Primary Care.

Objectives
To determine if there was any overall change in outcomes post injection when only steroid was used for a variety of musculoskeletal injections compared with the previous practice of mixing steroid with local anaesthetic.

Methods
Subjects were assessed using a numerical rating scale for pain between 0 and 10 before injection and 4 weeks post-injection, and also for the pain of the injection itself. The figures obtained were compared with those of previous audits within the same department.

Results
All average painscale scores were reduced 4 weeks after injection for all conditions. There is an overall average reduction in pain on provoking activity of 57.5%. Trigger finger/thumb (100%) and plantar fasciitis (93.2%) demonstrated the most significant reduction in pain. Pain of the injection gave an average score of 4.0 (3.8 in 2004).

Discussion and conclusions
Results are comparable with previous scores for injections carried out with steroid and local anaesthetic. This audit challenges the need for the addition of local anaesthetic to common musculoskeletal steroid injections. Contrary to a common patient perception, injection therapy is not an exceptionally painful experience. More robust research is required to explore this area in more detail.