可的松与皮质类固醇注射 资料

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

Efficacy by Condition

• Corticosteroid injections are effective in 57% of patients with trigger finger [10].
• Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores in rotator cuff repair patients [3].
• Corticosteroids are a favorable option for the management of trapeziometacarpal osteoarthritis given their affordability, ease of administration, and efficacy [11].
• When corticosteroid injection is used to treat adhesive capsulitis, both intra-articular and subacromial injection sites can be selected [15].

Steroid Type and Dosing

• Betamethasone injections resulted in a significantly shorter time to failure than triamcinolone injections for primary trigger finger [1].
• Triamcinolone is supported as a more viable corticosteroid option for shoulder injection compared to methylprednisolone [4].
• An injection targeting the extensor pollicis brevis subcompartment alone in de Quervain disease can reduce the dose of steroids used, potentially decreasing complications [8].
• No complications were observed for 4 mg triamcinolone injections for trigger finger when administered at intervals of at least 1 month [12].

Safety and Timing

• Corticosteroid injections should be administered only after the first postoperative month following rotator cuff repair to minimize the potential risk for adverse events [2].
• An interval of at least three months is recommended between corticosteroid injection and shoulder arthroplasty [19].
• There were no conclusive data to suggest an increased risk of retear or infection with corticosteroid injection use based on a subjective synthesis of ranges [5].

Contraindications

• Corticosteroid injections should not be used to treat most patients with tennis elbow with symptom duration of less than 12 months [6].

How It Works

Efficacy and Outcomes by Condition

• Local corticosteroid injection provides greater clinical improvement in symptoms 1 month after injection compared with placebo for carpal tunnel syndrome [13].
• Local corticosteroid injection provides significantly greater improvement than oral corticosteroid for up to 3 months for carpal tunnel syndrome [13].
• Local corticosteroid injection does not significantly improve outcomes compared with anti-inflammatory treatment, splinting, or laser treatment beyond 8 weeks for carpal tunnel syndrome [13].
• Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores after rotator cuff repair [3].
• The significant short term benefits of corticosteroid injection for tennis elbow are reversed after six weeks, with high recurrence rates [9].
• Combining a corticosteroid injection with exercise is not superior to exercise or no exercise for plantar fasciopathy [7].

Steroid Type and Dosing

• An injection targeting the extensor pollicis brevis subcompartment alone can reduce the dose of steroids used in de Quervain disease [8].

Safety and Complications

• No complications were observed for 4 mg triamcinolone injections when administered at intervals of at least 1 month for trigger finger [12].
• Local corticosteroid injection to the shoulder can create a significant, short-term increase in systemic glucose levels in patients with type 2 diabetes not treated with insulin [20].
• Serial saline solution injections are a promising, cost-effective, and low-risk treatment option for subcutaneous lipoatrophy and skin depigmentation following cortisone injection in the elbow [17].

Timing and Surgical Context

• Corticosteroid injections should be administered only after the first postoperative month to minimize the potential risk for adverse events following rotator cuff repair [2].
• Preoperative corticosteroid injection at all studied timepoints was not associated with an increased risk of postoperative deep infection after carpal tunnel release [16].

Contraindications and Cautions

• Corticosteroid injection for tennis elbow should be used with caution due to high recurrence rates after six weeks [9].

What the Evidence Shows

Trigger Finger

• Betamethasone injections resulted in a significantly shorter time to failure than triamcinolone injections [1].
• There is a statistically significant difference in pain during and shortly after injection when using a steroid with lidocaine versus steroid alone, but that difference may not be clinically relevant [27].

Lateral Epicondylitis (Tennis Elbow)

• The significant short term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in the management of tennis elbow [9].
• A single, blinded injection of corticosteroid medication was associated with poorer long-term outcomes and higher recurrence rates 1 year after receiving an injection in patients with unilateral lateral epicondylalgia [22].
• Corticosteroid injections for the treatment of lateral epicondylitis are superior to platelet-rich plasma at 1 month [18].
• Platelet-rich plasma is more effective than corticosteroid injections at 6 months for the treatment of lateral epicondylitis [18].
• Platelet-rich plasma is superior to corticosteroid injections at 3 months for the treatment of lateral epicondylitis [18].

Rotator Cuff

• Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores in rotator cuff disease [3].
• There were no conclusive data to suggest an increased risk of retear or infection with corticosteroid injection use based on a subjective synthesis of ranges regarding rotator cuff repair [5].
• Timing of a single preoperative corticosteroid injection within 1 year of rotator cuff repair did not significantly affect failure rates, patient-reported outcomes, range of motion, or strength [26].
• Corticosteroids have better efficacy in short term for rotator cuff disease treatment compared to platelet-rich plasma [23].
• Platelet-rich plasma is more beneficial for longterm recovery in rotator cuff disease treatment compared to corticosteroids [23].

Shoulder (General)

• Intra-articular steroid injection is effective and safe for frozen shoulder, relieving pain, improving functional performance, and increasing range of motion [25].

Carpal Tunnel Syndrome

• Local corticosteroid injection provides greater clinical improvement in symptoms 1 month after injection compared with placebo [13].
• Corticosteroid injection is safe and effective for the temporary relief of carpal tunnel syndrome symptoms [24].
• Most patients with carpal tunnel syndrome will eventually require surgery for long-term control of their symptoms despite corticosteroid injection [24].

Thumb Carpometacarpal Joint

• Corticosteroids are a favorable option when considering the choice of intra-articular injection for the management of trapeziometacarpal osteoarthritis given their affordability, ease of administration, and efficacy [11].
• There is lack of robust evidence to support use of image guidance to improve accuracy and clinical effectiveness of steroid injection for thumb carpometacarpal joint osteoarthritis [14].

Plantar Fasciopathy

• Combining a corticosteroid injection with exercise is not superior to exercise or no exercise for patients with plantar fasciopathy [7].

Practical Considerations

Steroid Selection and Dosing

• An injection targeting the extensor pollicis brevis subcompartment alone in de Quervain disease can reduce the dose of steroids used, potentially decreasing complications related to steroid injections [8].

Timing and Frequency

• Corticosteroid injections after rotator cuff repair should be administered only after the first postoperative month to minimize the potential risk for adverse events [2].

Efficacy and Outcomes

• Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores following rotator cuff repair [3].
• Combining a corticosteroid injection with exercise for plantar fasciopathy is not superior to exercise or no exercise [7].
• Corticosteroids are a favorable option for intra-articular injection in the management of trapeziometacarpal osteoarthritis given their affordability, ease of administration, and efficacy [11].
• Platelet-rich plasma has no advantage over steroid injections within the first month of treatment for lateral epicondylitis, but it is superior to steroids at both 3 and 6 months [18].

Safety and Complications

• There were no conclusive data to suggest an increased risk of retear or infection with corticosteroid injection use before or after primary rotator cuff repair based on a subjective synthesis of ranges [5].
• Corticosteroid and hyaluronic acid injections remain a safe treatment option regarding the risk of severe adverse events requiring hospitalization [21].

Imaging Guidance

• There is a lack of robust evidence to support the use of image guidance to improve accuracy and clinical effectiveness of steroid injection for thumb carpometacarpal joint osteoarthritis [14].

Key Evidence

• [L3] Betamethasone injections resulted in a significantly shorter time to failure than triamcinolone injections. [1] (10.1016/j.jhsa.2026.03.011)
• [L1] Corticosteroid injections should be administered only after the first postoperative month to minimize the potential risk for adverse events. [2] (10.1016/j.asmr.2021.10.010)
• [L4] Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores. [3] (10.1016/j.arthro.2020.04.044)
• [L2] This study supports TA as a more viable corticosteroid option for shoulder injection. [4] (10.1016/j.jse.2023.05.023)
• [L3] There were no conclusive data to suggest an increased risk of retear or infection with corticosteroid injection use based on a subjective synthesis of ranges. [5] (10.1016/j.arthro.2020.01.039)
• [Paper] Corticosteroid injections should not be used to treat most patients with tennis elbow with symptom duration of less than 12 months. [6] (10.1016/j.jsams.2009.09.009)
• [L1] The results indicate that combining a corticosteroid injection with exercise is not superior to exercise or no exercise. [7] (10.1136/bjsports-2023-106948)
• [L1] An injection targeting the EPB subcompartment alone can reduce the dose of steroids used, perhaps thereby decreasing complications related to steroid injections. [8] (10.1097/corr.0000000000002018)
• [L1] The significant short term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in the management of tennis elbow. [9] (10.1136/bmj.38961.584653.ae)
• [L1] Corticosteroid injections are effective in 57% of patients with trigger finger. [10] (10.5435/00124635-200703000-00006)
• [L1] Given the affordability, ease of administration, and efficacy associated with corticosteroids, they are a favorable option when considering the choice of intra-articular injection for the management of TMC OA. [11] (10.1016/j.jhsa.2024.02.001)
• [L4] No complications were observed for 4 mg triamcinolone injections when administered at intervals of at least 1 month. [12] (10.1016/j.jhsg.2025.01.005)
• [L1] Local corticosteroid injection provides greater clinical improvement in symptoms 1 month after injection compared with placebo and significantly greater improvement than oral corticosteroid for up to 3 months, but does not significantly improve outcomes compared with anti-inflammatory treatment, splinting, or laser treatment beyond 8 weeks. [13] (10.1177/1753193413490848)
• [L4] However, there is lack of robust evidence to support use of image guidance to improve accuracy and clinical effectiveness of steroid injection for thumb CMCJ and warrants further research. [14] (10.1177/17589983261430876)
• [L1] When corticosteroid injection is used to treat adhesive capsulitis, both injection sites can be selected. [15] (10.1155/2019/1274790)
• [L3] Preoperative corticosteroid injection at all studied timepoints was not associated with an increased risk of postoperative deep infection, a divergence from existing literature. [16] (10.5435/jaaos-d-25-00317)
• [L4] Serial saline solution injections are a promising, cost-effective, and low-risk treatment option for subcutaneous lipoatrophy and skin depigmentation following cortisone injection in the elbow. [17] (10.1016/j.jseint.2020.08.009)
• [L1] PRP has no advantage over steroid injections within the first month of treatment, but it is superior to steroids at both 3 and 6 months. [18] (10.1016/j.jse.2023.04.018)
• [L1] Thus, an interval of at least three months is recommended between injection and arthroplasty. [19] (10.1177/17585732241261659)
• [L2] Local corticosteroid injection to the shoulder can create a significant, short-term increase in systemic glucose levels in patients with type 2 diabetes not treated with insulin. [20] (10.1016/j.jseint.2022.05.016)
• [L2] Corticosteroid and hyaluronic acid injections remain a safe treatment option regarding the risk of severe adverse events requiring hospitalization. [21] (10.1186/s12891-026-09752-7)
• [L1] A single, blinded injection of corticosteroid medication was associated with poorer long-term outcomes and higher recurrence rates 1 year after receiving an injection in patients with unilateral lateral epicondylalgia. [22] (10.1001/jama.2013.129)
• [L1] Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for longterm recovery. [23] (10.1016/j.jse.2023.01.037)
• [L5] Corticosteroid injection is safe and effective for the temporary relief of carpal tunnel syndrome symptoms, but most patients will eventually require surgery for long-term control of their symptoms. [24] (10.1016/j.jhsa.2008.06.023)
• [L1] Intra-articular steroid injection is effective and safe for frozen shoulder, relieving pain, improving functional performance, and increasing range of motion. [25] (10.1177/0363546516669944)
• [L2] Timing of a single preoperative corticosteroid injection within 1 year of rotator cuff repair did not significantly affect failure rates, patient-reported outcomes, range of motion, or strength, suggesting that one injection before repair does not strongly influence outcomes. [26] (10.1016/j.jseint.2026.101632)
• [L2] There is a statistically significant difference in pain during and shortly after injection when using a steroid with lidocaine versus steroid alone, but that difference may not be clinically relevant. [27] (10.1016/j.jhsa.2024.05.016)

References

[1] The Effect of Corticosteroid Type on Failure Following Primary Trigger Finger Injection. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.03.011

[2] Corticosteroid Injections After Rotator Cuff Repair Improve Function, Reduce Pain, and Are Safe: A Systematic Review. Arthroscopy, Sports Medicine, and Rehabilitation. 2021. DOI: 10.1016/j.asmr.2021.10.010

[3] Corticosteroid Injections May Increase Retear and Revision Rates of Rotator Cuff Repair: A Systematic Review. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.04.044

[4] Comparison of triamcinolone and methylprednisolone efficacy and steroid flare reaction rates after shoulder corticosteroid injection: a prospective interrupted time series study. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.05.023

[5] Do Corticosteroid Injections Before or After Primary Rotator Cuff Repair Influence the Incidence of Adverse Events? A Subjective Synthesis. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.01.039

[6] Stop injecting corticosteroid into patients with tennis elbow, they are much more likely to get better by themselves!. Journal of Science and Medicine in Sport. 2010. DOI: 10.1016/j.jsams.2009.09.009

[7] Does a corticosteroid injection plus exercise or exercise alone add to the effect of patient advice and a heel cup for patients with plantar fasciopathy? A randomised clinical trial. British Journal of Sports Medicine. 2023. DOI: 10.1136/bjsports-2023-106948

[8] Is a Steroid Injection in Both Compartments More Effective than an Injection in the Extensor Pollicis Brevis Subcompartment Alone in Patients with de Quervain Disease? A Randomized, Controlled Trial. Clinical Orthopaedics & Related Research. 2021. DOI: 10.1097/corr.0000000000002018

[9] Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006. DOI: 10.1136/bmj.38961.584653.ae

[10] Corticosteroid Injections in the Treatment of Trigger Finger: A Level I and II Systematic Review. Journal of the American Academy of Orthopaedic Surgeons. 2007. DOI: 10.5435/00124635-200703000-00006

[11] Efficacy of Intra-Articular Corticosteroid Injection for Nonsurgical Management of Trapeziometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.02.001

[12] Safety and Efficacy of Low-Dose Triamcinolone Injection without Injection Frequency Limitation for Trigger Finger. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.01.005

[13] Cochrane corner: local corticosteroid injection for carpal tunnel syndrome. Journal of Hand Surgery (European Volume). 2013. DOI: 10.1177/1753193413490848

[14] Guided steroid injection for thumb carpometacarpal joint (CMCJ) osteoarthritis: A scoping review. Hand Therapy. 2026. DOI: 10.1177/17589983261430876

[15] Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review. BioMed Research International. 2019. DOI: 10.1155/2019/1274790

[16] Ipsilateral Preoperative Corticosteroid Injection and Timing Not Associated With Postoperative Deep Infection After Carpal Tunnel Release. Journal of the American Academy of Orthopaedic Surgeons. 2025. DOI: 10.5435/jaaos-d-25-00317

[17] Serial saline solution injections for the treatment of lipoatrophy and depigmentation after corticosteroid injection for medial epicondylitis. JSES International. 2020. DOI: 10.1016/j.jseint.2020.08.009

[18] Corticosteroid injections for the treatment of lateral epicondylitis are superior to platelet-rich plasma at 1 month but platelet-rich plasma is more effective at 6 months: an updated systematic review and meta-analysis of level 1 and 2 studies. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.04.018

[19] The safety of corticosteroid injection prior to shoulder arthroplasty: A systematic review. Shoulder & Elbow. 2024. DOI: 10.1177/17585732241261659

[20] The effect of steroid injection into the shoulder on glycemia in patients with type 2 diabetes. JSES International. 2022. DOI: 10.1016/j.jseint.2022.05.016

[21] Safety of intra-articular corticosteroid and hyaluronic acid injections: a 14-year population-based cohort study of 404,797 patients. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09752-7

[22] Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia. JAMA. 2013. DOI: 10.1001/jama.2013.129

[23] Comparison of the effects of platelet-rich plasma and corticosteroid injection in rotator cuff disease treatment: a systematic review and meta-analysis. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.01.037

[24] Corticosteroid Injection for Carpal Tunnel Syndrome. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.06.023

[25] Intra-articular Steroid Injection for Frozen Shoulder: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis. The American Journal of Sports Medicine. 2016. DOI: 10.1177/0363546516669944

[26] Timing of corticosteroid injection within 1 year prior to rotator cuff repair was not associated with increased risk of repair failure. JSES International. 2026. DOI: 10.1016/j.jseint.2026.101632

[27] Corticosteroid Injection With and Without Local Anesthetic for the Treatment of Trigger Finger: A Randomized Clinical Trial. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.05.016