Assessment of pain during intra-articular injection with corticosteroid and its related variables: a cross-sectional study in patients with rheumatic disease

Abstract Objectives To evaluate the mean pain level during intra-articular injection (IAI) with corticosteroid and its associated variables. Methods A cross-sectional study with adult patients with rheumatic diseases, joint swelling and pain > 1 month, receiving a single IAI of triamcinolone hexacetonide (TH). Joints were assessed for pain (VAS 0–10 cm), swelling, demographic data, disease type, fibromyalgia presence, joint size/type, and IAI variables (needle size, TH dose). Pain during IAI (VASIIA) was measured blindly. Joints were divided into High Pain Group (HPG, VASIIA > mean) and Low Pain Group (LPG, VASIIA ≤ mean). Comparisons used three analyses: full sample, excluding fibromyalgia, and a subgroup with VASIIA ≥ 7. Results 399 joints from 246 patients (mean age 63.6 years, 86.2% women) were studied. Mean VASIIA was 4.8. In Analysis 1, lower pre-IAI VAS scores linked to LPG. Analysis 2 showed that lower pain VAS and rheumatoid arthritis were associated with LPG. Analysis 3 found that LPG was associated with lower pre-IAI pain, rheumatoid arthritis, younger age, and multiple rheumatic diseases. Conclusion The mean pain during IAI was moderate. Variables associated with lower pain levels included younger age, lower pre-IAI pain, rheumatoid arthritis, and multiple rheumatic conditions. These findings suggest that patient and disease characteristics influence pain perception during joint injections, which could guide personalized pain management strategies in rheumatology.