What are the guidelines for the choice of corticosteroid and local anesthetic for joint injections?

Current guidelines for selecting corticosteroids and local anesthetics for joint injections:

• Consider intra-articular corticosteroid injections for osteoarthritis when other pharmacological treatments are ineffective or unsuitable, or to support therapeutic exercise. These injections provide only short-term relief, typically lasting 2 to 10 weeks.
• There is no specific guidance in the provided NICE osteoarthritis or rheumatoid arthritis guidelines on the choice of corticosteroid type or local anesthetic agent for joint injections.
• Local anesthetics are commonly used in practice alongside corticosteroids for joint injections to provide immediate pain relief, but the guidelines focus on the indication and timing rather than specific agent selection.
• In rheumatoid arthritis management, corticosteroids may be used as bridging treatment but specific recommendations on corticosteroid or local anesthetic selection for joint injections are not detailed in the provided excerpts.

Therefore, the key guideline recommendation is to consider intra-articular corticosteroid injections when other treatments fail or are unsuitable, with an understanding of their short-term benefit, but the choice of corticosteroid and local anesthetic agent is not explicitly specified in the current NICE guidelines.

References: NICE NG226,NICE NG100