Steroids are injected into joints for various indications. All
steroid preparations relieve
pain similarly over the long term. Therefore, decisions about which preparation to use are often arbitrary. We evaluated
methylprednisolone acetate and a combination of
betamethasone diproprionate and
betamethasone sodium phosphate for short-term
pain and the predictive value of short-term
pain. Eighty-five patients were injected in prospective double-blind randomized fashion.
Pain was evaluated by visual analog scale (1 = no
pain, 10 = severe
pain) at baseline, 3 days, and 3 weeks. No patient had
joint pain immediately after injection. Three days after injection, mean (SD)
pain levels were 5.1 (2.9) for
methylprednisolone and 5.2 (2.6) for
betamethasone (P = .97); 3 weeks after injection, they were 4.0 (2.8) and 3.7 (2.5), respectively (P = .57). Short-term
pain increased from baseline for both preparations and decreased from 3 days to 3 weeks.
Pain at 3 days and 3 weeks was positively correlated. This study does not support a difference in short-term
pain between preparations. The significant correlation between short- and long-term
pain may justify early decisions regarding treatment, especially in patients with high levels of initial
pain.