Intra-Articular Analgesia and Steroid Reduce Pain Sensitivity in Knee OA Patients: An Interventional Cohort Study.

Tanja Schjødt Jørgensen,Bente Danneskiold-Samsøe,Marius Henriksen,Karen Ellegaard,Henning Bliddal,Thomas Graven-Nielsen

doi:10.1155/2014/710490

Abstract

Objectives. To assess the effects of intra-articular therapy on pain sensitivity in the knee and surrounding tissues in knee OA patients. Methods. Twenty-five knee OA patients with symptomatic knee OA were included in this interventional cohort study. Pressure pain thresholds (PPT) were recorded before, immediately after, and two weeks after ultrasound guided intra-articular injection of lidocaine combined with glucocorticosteroid. Computer-controlled and manual pressure algometers were used to assess PPT on the knee, vastus lateralis, tibialis anterior, and the extensor carpi radialis longus muscles (control site). Results. Significantly increased PPTs were found following intra-articular injection, at both the knee (P < 0.0001) and the surrounding muscles (P < 0.042). The treatment effects were sustained for two weeks, and at some points the effect was even greater at two weeks (P < 0.026). Albeit not statistically significant, a similar trend was observed at the control site. Conclusions. Intra-articular anesthesia, combined with glucocorticosteroid, reduced pain sensitivity in both the knee and surrounding muscles for at least two weeks.

Highlights

Osteoarthritis (OA) is a common chronic pain condition
Hyperalgesia and widespread pain were shown in knee OA patients, as both the knee and the surrounding sites were hyperalgesic to pressure pain stimulations compared with healthy controls [6]
25 knee OA patients with symptomatic knee OA were included in this interventional cohort study (Figure 1)

Summary

Introduction

There is growing consensus that knee OA involves a lowgrade inflammation contributing to structural disease progression and generation and maintenance of pain [1,2,3]. Hyperalgesia and widespread pain were shown in knee OA patients, as both the knee and the surrounding sites were hyperalgesic to pressure pain stimulations compared with healthy controls [6]. Total knee replacement reduced the knee hyperalgesia and sensitisation phenomena, besides reducing the clinical pain intensity [7].

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Conclusion