Effect of ice on pain after corticosteroid injection in the hand and wrist: a randomized controlled trial

This prospective, randomized controlled study was designed to determine if applying ice to the site of corticosteroid injections in the hand and wrist reduces post-injection pain. Patients receiving corticosteroid injections in the hand or wrist at a tertiary institution were enrolled. Subjects were randomized to apply ice to the injection site and take scheduled over-the-counter analgesics (n=36) or take scheduled over-the-counter analgesics alone (n=32). There were no significant differences in the mean pain score between the two groups at any time-point (pre-injection or 1-5days post-injection). In regression modelling, the application of ice did not predict pain after injection. Visual analogue pain scores increased at least 2 points (0-10 scale) after injection in 17 out of 36 patients in the ice group versus ten out of 32 control patients. We conclude that the application of ice in addition to over-the-counter analgesics does not reduce post-injection pain after corticosteroid injection in the hand or wrist. Level of Evidence: I Therapeutic Study