What role do corticosteroid injections play in the management of De Quervain's tenosynovitis, and how effective are they?

Corticosteroid injections play a significant role in the management of De Quervain's tenosynovitis by providing effective short-term symptom relief. Evidence from randomized controlled trials indicates that local corticosteroid injections, such as methylprednisolone acetate, combined with immobilization (casting), are more effective than casting alone in reducing pain and improving function in patients with De Quervain's tenosynovitis Mehdinasab 2010. Additionally, corticosteroid injections have demonstrated superior efficacy compared to acupuncture in symptom relief Hadianfard et al. 2014.

While UK clinical guidelines do not explicitly detail corticosteroid injection use for De Quervain's tenosynovitis, the available literature supports their use as a conservative treatment option before considering surgical intervention. The injections are generally well tolerated and can provide rapid improvement in symptoms, which is valuable in primary care management.

However, it is important to consider that corticosteroid injections may provide primarily short-term benefits, and repeated injections carry risks such as tendon damage, as seen in other musculoskeletal conditions (CKS - Shoulder pain NICE CKS). Therefore, injections should be administered by trained practitioners with appropriate patient consent and monitoring.

In summary, corticosteroid injections are an effective conservative treatment for De Quervain's tenosynovitis, offering significant short-term pain relief and functional improvement, especially when combined with immobilization. Their use should be balanced against potential risks and considered within a stepwise management approach.