Periarticular Magnesium Injection Therapy Provides Pain Relief and Enables Steroid Avoidance in Sickle Cell Arthropathy Patients

Background: Sickle cell disease (SCD) is associated with arthropathy. Arthropathy pain may require periarticular injection therapy. However, steroid injections may be unsuitable for SCD patients. Alternatively, magnesium injection may provide analgesia and avoid steroid requirement. This is a study of the impact of periarticular injection therapy on pain, sleep, and walking function improvement in SCD. It studied periarticular magnesium injection versus periarticular dexamethasone injection in SCD and matched non-SCD patients. Methods: This is an observational study of twenty adults with severe arthropathy. Data collected included patients’ pain score, walking function score, sleep score, and periarticular injection therapy outcomes. Walking ability was assessed using the arthritis self-efficacy scale of 10-100. Pain was measured using the 10-point numeric scale. Sleep was assessed using the 10-point Likert scale. Results: Ten consecutive SCD patients were matched with ten non-SCD patients with similar clinical characteristics. Eleven patients had knee arthropathy, and nine patients had hip arthropathy. Twelve patients used codeine analgesic, and eight patients used tramadol analgesic regularly. The patients’ pre-treatment numeric pain scores were 7-9, Likert sleep scores were 2-4, and walking function scores were 20-30. Periarticular magnesium or dexamethasone injections produced similar improvements in the walking function, pain, and sleep scores of the SCD and non-SCD patients. One SCD patient developed a sickle cell crisis after a dexamethasone injection. One non-SCD patient experienced insomnia after dexamethasone injection. Magnesium injection was not associated with any complications. Conclusion: SCD arthropathy pain is severe. Periarticular magnesium injection provides safe and effective analgesia for SCD arthropathy. Periarticular dexamethasone injection may be employed in SCD patients with no hypothermia, infection, or immunocompromise. Magnesium injection is a better and safer alternative in clinical situations that require steroid avoidance. Periarticular magnesium injection therapy promotes value-based healthcare for SCD arthropathy patients.