People with rheumatic diseases who receive a corticosteroid injection directly into a painful, swollen joint experience, on average, moderate pain during the procedure, according to a cross-sectional study published in Advances in Rheumatology. The study measured pain during intra-articular injection of triamcinolone hexacetonide and identified which patient and disease characteristics were linked to lower reported pain levels.
The research team enrolled adult patients with rheumatic diseases who had joint swelling and pain lasting more than one month and who were due to receive a single intra-articular injection of triamcinolone hexacetonide. In total, the analysis covered 399 joints from 246 patients, whose mean age was 63.6 years and 86.2 percent of whom were women.
Pain during the injection was assessed using a visual analogue scale ranging from 0 to 10 centimetres, and the measurement was taken blindly. The researchers also recorded joint swelling, demographic data, disease type, the presence of fibromyalgia, joint size and type, and injection variables such as needle size and corticosteroid dose.
The mean pain score during injection was 4.8 on the 0-to-10 scale, which the authors characterise as moderate. To explore what distinguished more painful from less painful injections, joints were divided into a High Pain Group, with scores above the sample mean, and a Low Pain Group, with scores at or below the mean.
The investigators then carried out three separate analyses. In the first, covering the full sample, lower pain scores before the injection were associated with membership in the Low Pain Group. In the second analysis, which excluded patients with fibromyalgia, lower pre-injection pain and a diagnosis of rheumatoid arthritis were associated with the Low Pain Group.
In the third analysis, focused on a subgroup of joints with injection pain scores of 7 or higher, the Low Pain Group was associated with lower pre-injection pain, rheumatoid arthritis, younger age, and having multiple rheumatic diseases. Taken together, the analyses point to both patient-level and disease-level characteristics as correlates of how much pain a patient reports during the procedure.
The authors conclude that variables associated with lower pain levels during injection included younger age, lower pain before the injection, rheumatoid arthritis, and multiple rheumatic conditions. They suggest that patient and disease characteristics influence pain perception during joint injections, and that this could inform personalised pain management strategies in rheumatology.
As a cross-sectional study, the work captures associations at a single point in time and cannot establish causal relationships between the measured variables and injection pain. The findings describe a specific population of adults with rheumatic diseases, joint swelling and chronic joint pain receiving a single corticosteroid injection, and the reported associations should be interpreted within that scope.
Subject of Research: Pain levels during intra-articular corticosteroid injection in patients with rheumatic disease and the variables associated with them.
Article Title: Assessment of pain during intra-articular injection with corticosteroid and its related variables: a cross-sectional study in patients with rheumatic disease
Article References: Vendramine, S. F., Natour, J., Dos Santos, M. F., Paschoal, N. S., Oliveira, J. V. C. D., Silva, K. R., & Furtado, R. N. V. (2026). Assessment of pain during intra-articular injection with corticosteroid and its related variables: a cross-sectional study in patients with rheumatic disease. Advances in Rheumatology. https://doi.org/10.1186/s42358-026-00581-9
Image Credits: AI Generated
DOI: 10.1186/s42358-026-00581-9
Keywords: intra-articular injection, corticosteroid, triamcinolone hexacetonide, pain, rheumatic diseases, rheumatoid arthritis, cross-sectional study, visual analogue scale, fibromyalgia, rheumatology, joint injection, Assessment
News Source: Ophelia Keating. (October 28, 2026). Joint injections hurt moderately, and patient traits shape how much, study finds. Scienmag.
