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Cortisone and Corticosteroid Injections

What cortisone injections do, when they help, how long the effect lasts, and the risks of repeated injections for shoulder, elbow, wrist and hand conditions.

51 citationsUpdated Oct 2026
Illustration: Cortisone and Corticosteroid Injections

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Corticosteroid injections serve as a primary conservative intervention for various orthopaedic conditions, including trigger finger, rotator cuff pathology, and adhesive capsulitis. For trigger finger and thumb, steroid injection is an appropriate first treatment in most patients, with effects that are not unreliable or temporary, contradicting recommendations for immediate operation [11]. The procedure is effective in 57% of patients with trigger finger [15] and provides benefit by relieving pain and improving functional outcome scores following rotator cuff repair [5]. In adhesive capsulitis, both intra-articular and subacromial injection sites can be selected [19], while for trapeziometacarpal osteoarthritis, corticosteroids are a favorable option given their affordability, ease of administration, and efficacy [21].

The clinical utility of these injections varies by condition and timing. For tennis elbow with symptom duration of less than 12 months, corticosteroid injections should not be used to treat most patients [13], as significant short-term benefits are reversed after six weeks with high recurrence rates [14]. In rotator cuff repair, injections should be administered only after the first postoperative month to minimize adverse events [4], although no conclusive data suggest an increased risk of retear or infection based on a subjective synthesis of ranges [8]. For carpal tunnel syndrome, injection is safe and effective for temporary relief, but most patients will eventually require surgery for long-term control [33]. Additionally, combining a corticosteroid injection with exercise is not superior to exercise or no exercise for plantar fasciopathy [2].

Safety profiles and specific agent choices influence clinical decision-making. Triamcinolone is supported as a more viable option for shoulder injection compared to methylprednisolone [6], and no complications were observed for 4 mg triamcinolone injections when administered at intervals of at least 1 month for trigger finger [17]. However, flexor pollicis longus tendon rupture is considered related to corticosteroid injection, suggesting persistent atrophic change [24]. An interval of at least three months is recommended between corticosteroid injection and shoulder arthroplasty [34], and it is recommended to wait for at least one month before considering another injection or alternative treatments after steroid injection for first presentation trigger digits [50]. Future studies should standardize reporting of corticosteroid exposure, including cumulative dose, peak dose, route, duration, and timing relative to symptom onset or diagnosis [1].

How It Works

Efficacy and Outcomes

Corticosteroid injections demonstrate variable efficacy depending on the pathology and timeframe. For stenosing tenovaginitis, complete relief of symptoms was obtained in 76% of digits treated with repeated corticosteroid injections [30]. In subacromial impingement syndrome, subacromial steroid injection is an effective therapy [27]. For carpal tunnel syndrome, local corticosteroid injection provides greater clinical improvement in symptoms 1 month after injection compared with placebo [18]. Furthermore, local corticosteroid injection provides significantly greater improvement than oral corticosteroid for up to 3 months for carpal tunnel syndrome [18]. However, local corticosteroid injection does not significantly improve outcomes compared with anti-inflammatory treatment, splinting, or laser treatment beyond 8 weeks for carpal tunnel syndrome [18]. Regarding trigger fingers and thumbs, corticosteroid injections are not considered unreliable and temporary for their treatment [11].

Comparative Efficacy and Formulations

Formulation choices influence pain profiles and failure rates. Betamethasone injections resulted in a significantly shorter time to failure than triamcinolone injections for primary trigger finger injection [3]. Aspiration plus steroid injection offers no advantage over simple aspiration for wrist ganglia [10]. Lidocaine addition creates a statistically significant difference in pain during and shortly after injection when using a steroid with lidocaine versus steroid alone for trigger finger, but that difference may not be clinically relevant [29]. Percutaneous release of trigger digit leaves negligible or intermittent pain persisting for 8 weeks in the noncortisone group and 6 weeks in the cortisone group [25].

Safety, Complications, and Adverse Effects

Safety profiles vary by anatomical site and patient population. Rotator cuff repair patients should receive corticosteroid injections only after the first postoperative month to minimize the potential risk for adverse events [4]. 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 [8]. Carpal tunnel release patients show no association between preoperative corticosteroid injection at all studied timepoints and an increased risk of postoperative deep infection [20]. Lateral epicondylitis presents a significant association of steroid injections with soft-tissue calcification, suggesting that this calcification is likely to be an iatrogenic complication of steroid injection [16]. Tendon integrity is compromised by histological analysis at 1-week post-injection, which showed collagen attenuation, increased expression of MMP-3 and apoptotic cells in the corticosteroid groups [22]. Flexor pollicis longus tendon rupture is considered related to steroid injection, suggesting that persistent atrophic change from the injection is a likely scenario [24]. Cartilage is vulnerable, as triamcinolone hexacetonide exhibits chondrotoxic effects dependent on time and dosage, raising concern regarding the potential risk of intra-meniscal corticosteroid injection [26]. Repeated subacromial injections of triamcinolone may cause damage to the rotator cuff, indicating cautious use of subacromial steroid injections in human beings [39]. Metabolic effects include a significant, short-term increase in systemic glucose levels in patients with type 2 diabetes not treated with insulin following local corticosteroid injection to the shoulder [38]. Kienböck's disease may have corticosteroid administration as an additional factor in its multifactorial causes [37]. Skin and fat complications such as subcutaneous lipoatrophy and skin depigmentation following cortisone injection in the elbow can be treated with serial saline solution injections, a promising, cost-effective, and low-risk option [28].

Timing and Long-Term Effects

Long-term outcomes often diverge from short-term benefits. The significant short term benefits of corticosteroid injection for tennis elbow are paradoxically reversed after six weeks, with high recurrence rates [14]. In the ankle, three weeks after injury, joint stiffness increased 34% in ankles injected with the steroid, which was significantly less than the 133% increase in saline-injected ankles and the 224% increase in ankles treated with no injection [40].

Mechanism of Action

Corticosteroids exert their effects through specific molecular pathways. The cartilage-specific (V + C) fibronectin isoform was suppressed in both normal and inflamed joints by a single intraarticular injection of methylprednisolone [35]. Additionally, treatment with corticosteroids suppressed expression of MMP-1, -3, and -13 mRNA in equine cartilage [36].

What the Evidence Shows

Trigger Finger and Stenosing Tenovaginitis

Steroid injection is considered an appropriate first treatment for trigger finger in most patients [12]. For patients with recurrent trigger finger who prefer nonsurgical management, repeated corticosteroid injections should be considered, particularly in those without factors predictive of failure [51].

Lateral Epicondylitis and Tennis Elbow

The significant short-term benefits of corticosteroid injection for tennis elbow are reversed after six weeks, with high recurrence rates [14]. A single, blinded injection of corticosteroid medication was associated with poorer long-term outcomes and higher recurrence rates one year after receiving an injection in patients with unilateral lateral epicondylalgia [41]. Corticosteroid injections for the treatment of lateral epicondylitis are superior to platelet-rich plasma at one month, but platelet-rich plasma is more effective at six months [32]. 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 three and six months [32]. There is a significant association of steroid injections with soft-tissue calcification in lateral epicondylitis, suggesting this calcification is likely an iatrogenic complication [16].

Rotator Cuff and Shoulder

Corticosteroid injections after rotator cuff repair improve function, reduce pain, and are safe [4]. Corticosteroid injections should be administered only after the first postoperative month following rotator cuff repair to minimize the potential risk for adverse events [4]. Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores in rotator cuff repair patients [5]. 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 for rotator cuff repair [8]. Timing of a single preoperative corticosteroid injection within one year of rotator cuff repair did not significantly affect failure rates, patient-reported outcomes, range of motion, or strength [45]. Corticosteroids have better efficacy in the short term, whereas platelet-rich plasma is more beneficial for long-term recovery in rotator cuff disease [42].

Adhesive Capsulitis (Frozen Shoulder)

Intra-articular steroid injection is effective and safe for frozen shoulder, relieving pain, improving functional performance, and increasing range of motion [44].

Carpal Tunnel Syndrome

Both platelet-rich plasma and steroid injections were more effective than splinting alone in improving symptoms and function for bilateral moderate carpal tunnel syndrome [43].

De Quervain Disease

An injection targeting the extensor pollicis brevis subcompartment alone can reduce the dose of steroids used, perhaps thereby decreasing complications related to steroid injections for de Quervain disease [9]. Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients [49]. The effectiveness of each additional corticosteroid injection for de Quervain tenosynovitis does not appear to diminish in patients with diabetes mellitus [49].

Trapeziometacarpal Osteoarthritis

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 [21]. 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 [23].

Plantar Fasciopathy

Combining a corticosteroid injection with exercise is not superior to exercise or no exercise for patients with plantar fasciopathy [2].

Wrist Ganglia

Rock Climber's Tenosynovitis

General Safety and Mechanisms

Corticosteroid and hyaluronic acid injections remain a safe treatment option regarding the risk of severe adverse events requiring hospitalization [31]. Histological analysis at one-week post-injection showed collagen attenuation, increased expression of MMP-3, and apoptotic cells in the corticosteroid groups, associated with tendon degeneration or rupture [22]. Future studies should standardize reporting of corticosteroid exposure, including cumulative dose, peak dose, route, duration, and timing relative to symptom onset or diagnosis for atraumatic osteonecrosis of the humeral head [1].

Practical Considerations

Dosing and Reporting

Targeting the extensor pollicis brevis subcompartment alone allows for a reduction in the dose of steroids used. This targeted approach potentially decreases complications related to steroid injections [9].

Steroid Selection and Formulation

Triamcinolone hexacetonide exhibits chondrotoxic effects that are dependent on time and dosage. These properties raise concerns regarding the potential risk of intra-meniscal corticosteroid injection [26].

Timing and Frequency

Administering up to four corticosteroid injections before surgery for carpal tunnel syndrome reduced overall cost [48].

Efficacy and Comparative Outcomes

For lateral epicondylitis, corticosteroid injections are superior to platelet-rich plasma at 1 month [32]. Conversely, platelet-rich plasma is superior to corticosteroid injections at both 3 and 6 months for lateral epicondylitis [32]. A smaller cohort may have benefit for up to six months after one x-ray guided steroid injection for proximal interphalangeal joint osteoarthritis [46].

Safety and Complications

Positive outcomes after corticosteroid injection therapy for rock climber's tenosynovitis were observed with the absence of complications [7].

Technique and Guidance

Volar corticosteroid injection for distal interphalangeal ganglion cysts allows for ease and consistency of needle placement for intra-articular delivery. This technique minimizes potential soft tissue and infection concerns [47].

Key Evidence

  • [L4] Future studies should standardize reporting of corticosteroid exposure, including cumulative dose, peak dose, route, duration, and timing relative to symptom onset or diagnosis. [1] (10.1016/j.xrrt.2026.100877)
  • [L1] The results indicate that combining a corticosteroid injection with exercise is not superior to exercise or no exercise. [2] (10.1136/bjsports-2023-106948)
  • [L3] Betamethasone injections resulted in a significantly shorter time to failure than triamcinolone injections. [3] (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. [4] (10.1016/j.asmr.2021.10.010)
  • [L4] Corticosteroid injections provide benefit by relieving pain and improving functional outcome scores. [5] (10.1016/j.arthro.2020.04.044)
  • [L2] This study supports TA as a more viable corticosteroid option for shoulder injection. [6] (10.1016/j.jse.2023.05.023)
  • [L4] The positive outcome after corticosteroid injection therapy and the absence of complications justifies this invasive approach in rock climbing athletes. [7] (10.1016/j.hansur.2019.07.004)
  • [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. [8] (10.1016/j.arthro.2020.01.039)
  • [L1] An injection targeting the EPB subcompartment alone can reduce the dose of steroids used, perhaps thereby decreasing complications related to steroid injections. [9] (10.1097/corr.0000000000002018)
  • [L1] We conclude that there is no advantage to aspiration plus steroid injection over simple aspiration. [10] (10.1016/0266-7681(94)90334-4)
  • [L3] We disagree with authors who recommend an operation and who state that the effects of steroid injection are unreliable and temporary. [11] (10.1016/0363-5023(89)90199-8)
  • [L1] We feel that steroid injection is an appropriate first treatment for this condition in most patients. [12] (10.1016/0266-7681(92)90014-s)
  • [Paper] Corticosteroid injections should not be used to treat most patients with tennis elbow with symptom duration of less than 12 months. [13] (10.1016/j.jsams.2009.09.009)
  • [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. [14] (10.1136/bmj.38961.584653.ae)
  • [L1] Corticosteroid injections are effective in 57% of patients with trigger finger. [15] (10.5435/00124635-200703000-00006)
  • [L3] The significant association of steroid injections with soft-tissue calcification in LE suggests that this calcification is likely to be an iatrogenic complication of steroid injection. [16] (10.1016/j.jse.2018.10.009)
  • [L4] No complications were observed for 4 mg triamcinolone injections when administered at intervals of at least 1 month. [17] (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. [18] (10.1177/1753193413490848)
  • [L1] When corticosteroid injection is used to treat adhesive capsulitis, both injection sites can be selected. [19] (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. [20] (10.5435/jaaos-d-25-00317)
  • [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. [21] (10.1016/j.jhsa.2024.02.001)
  • [Paper] Histological analysis, at 1-week post-injection, showed collagen attenuation, increased expression of MMP-3 and apoptotic cells in the corticosteroid groups. [22] (10.1002/jor.22681)
  • [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. [23] (10.1177/17589983261430876)
  • [L5] The rupture is considered related to the steroid injection, suggesting that persistent atrophic change from the injection is a likely scenario. [24] (10.1016/s0363-5023(96)80172-9)
  • [L3] Negligible or intermittent pain persisted for 8 weeks in the noncortisone group and 6 weeks in the cortisone group after percutaneous release. [25] (10.1016/s0363-5023(05)80196-0)
  • [L5] The authors express concern regarding the potential risk of intra-meniscal corticosteroid injection, noting that triamcinolone hexacetonide exhibits chondrotoxic effects dependent on time and dosage. [26] (10.1016/j.otsr.2024.104049)
  • [L1] We conclude that the use of subacromial steroid injection is an effective therapy for the treatment of subacromial impingement syndrome. [27] (10.1016/s1058-2746(96)80094-2)
  • [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. [28] (10.1016/j.jseint.2020.08.009)
  • [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. [29] (10.1016/j.jhsa.2024.05.016)
  • [L4] Complete relief of symptoms was obtained in 76% of digits treated with repeated corticosteroid injections. [30] (10.1016/0266-7681_89_90138-1)
  • [L2] Corticosteroid and hyaluronic acid injections remain a safe treatment option regarding the risk of severe adverse events requiring hospitalization. [31] (10.1186/s12891-026-09752-7)
  • [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. [32] (10.1016/j.jse.2023.04.018)
  • [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. [33] (10.1016/j.jhsa.2008.06.023)
  • [L1] Thus, an interval of at least three months is recommended between injection and arthroplasty. [34] (10.1177/17585732241261659)
  • [Paper] The cartilage-specific (V + C) fibronectin isoform was suppressed in both normal and inflamed joints by a single intraarticular injection of methylprednisolone. [35] (10.1016/s0736-0266(00)00060-7)
  • [Paper] Treatment with corticosteroids suppressed expression of MMP-1, -3, and -13 mRNA. [36] (10.1002/jor.21001)
  • [L5] This case suggests that corticosteroid administration may be an additional factor in the multifactorial causes of Kienböck's disease. [37] (10.1016/0363-5023(89)90024-5)
  • [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. [38] (10.1016/j.jseint.2022.05.016)
  • [Paper] These results show that repeated subacromial injections of triamcinolone may cause damage to the rotator cuff of the rat, indicating cautious use of subacromial steroid injections in human beings. [39] (10.1016/s1058-2746(99)90141-6)
  • [Paper] Three weeks after injury, joint stiffness increased 34% in ankles injected with the steroid, which was significantly less than the 133% increase in saline-injected ankles and the 224% increase in ankles treated with no injection. [40] (10.1016/s0363-5023(09)91083-8)
  • [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. [41] (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. [42] (10.1016/j.jse.2023.01.037)
  • [L1] Both PRP and steroid injections were more effective than splinting alone in improving symptoms and function. [43] (10.1016/j.injury.2026.113018)
  • [L1] Intra-articular steroid injection is effective and safe for frozen shoulder, relieving pain, improving functional performance, and increasing range of motion. [44] (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. [45] (10.1016/j.jseint.2026.101632)
  • [L4] A smaller cohort may have benefit for up to six months after one injection. [46] (10.1142/s0218810417500277)
  • [L4] This technique allows for ease and consistency of needle placement for intra-articular corticosteroid delivery while minimizing the potential soft tissue and infection concerns described with other techniques. [47] (10.1177/1558944717744336)
  • [L3] Cost analysis revealed that giving up to four injections before surgery reduced overall cost. [48] (10.1177/17531934251396629)
  • [L4] Patients with diabetes mellitus have a decreased probability of success following a single corticosteroid injection for de Quervain tenosynovitis in comparison to nondiabetic patients, but the effectiveness of each additional injection does not appear to diminish. [49] (10.1016/j.jhsa.2022.02.018)
  • [L3] It is recommended to wait for at least one month before considering another injection or alternative treatments. [50] (10.1142/s2424835520500253)
  • [L2] Repeated corticosteroid injections for recurrent trigger finger should be considered in patients who prefer nonsurgical treatment, especially in those without factors predictive of failure. [51] (10.1016/j.jhsa.2023.12.002)

See Also

  • Osteoarthritis

References

[1] Corticosteroid Dose Reporting in Atraumatic Osteonecrosis of the Humeral Head: A Scoping Review. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2026.100877

[2] 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

[3] 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

[4] 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

[5] 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

[6] 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

[7] Efficacy of corticosteroid injection in rock climber's tenosynovitis. Hand Surgery and Rehabilitation. 2019. DOI: 10.1016/j.hansur.2019.07.004

[8] 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

[9] 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

[10] Conservative Management of Wrist Ganglia: Aspiration Versus Steroid Injection. Journal of Hand Surgery. 1994. DOI: 10.1016/0266-7681(94)90334-4

[11] Efficacy of cortisone injection in treatment of trigger fingers and thumbs. The Journal of Hand Surgery. 1989. DOI: 10.1016/0363-5023(89)90199-8

[12] Controlled Study of the Use of Local Steroid Injection in the Treatment of Trigger Finger and Thumb. Journal of Hand Surgery. 1992. DOI: 10.1016/0266-7681(92)90014-s

[13] 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

[14] 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

[15] 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

[16] Association of steroid injection with soft-tissue calcification in lateral epicondylitis. Journal of Shoulder and Elbow Surgery. 2019. DOI: 10.1016/j.jse.2018.10.009

[17] 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

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

[19] 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

[20] 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

[21] 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

[22] Temporary inductions of matrix metalloprotease-3 (MMP-3) expression and cell apoptosis are associated with tendon degeneration or rupture after corticosteroid injection. Journal of Orthopaedic Research. 2014. DOI: 10.1002/jor.22681

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

[24] Flexor pollicis longus tendon rupture after corticosteroid injection. The Journal of Hand Surgery. 1996. DOI: 10.1016/s0363-5023(96)80172-9

[25] Percutaneous release of trigger digit with and without cortisone injection. The Journal of Hand Surgery. 1997. DOI: 10.1016/s0363-5023(05)80196-0

[26] Intra-meniscal corticosteroid injections: Easier said than done. Orthopaedics & Traumatology: Surgery & Research. 2025. DOI: 10.1016/j.otsr.2024.104049

[27] An analysis of the efficacy of corticosteroid injections for the treatment of subacromial impingement syndrome. Journal of Shoulder and Elbow Surgery. 1996. DOI: 10.1016/s1058-2746(96)80094-2

[28] 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

[29] 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

[30] A Long-Term Follow-Up of the Effect of Repeated Corticosteroid Injections for Stenosing Tenovaginitis. Journal of Hand Surgery. 1989. DOI: 10.1016/0266-7681_89_90138-1

[31] 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

[32] 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

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

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

[35] Corticosteroids alter the differentiated phenotype of articular chondrocytes. Journal of Orthopaedic Research. 2001. DOI: 10.1016/s0736-0266(00)00060-7

[36] MMP‐mediated collagen breakdown induced by activated protein C in equine cartilage is reduced by corticosteroids. Journal of Orthopaedic Research. 2009. DOI: 10.1002/jor.21001

[37] Kienböck's disease in a patient with Crohn's enteritis treated with corticosteroids. The Journal of Hand Surgery. 1989. DOI: 10.1016/0363-5023(89)90024-5

[38] 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

[39] Effect of steroid injections on the rotator cuff: An experimental study in rats. Journal of Shoulder and Elbow Surgery. 1999. DOI: 10.1016/s1058-2746(99)90141-6

[40] Intra-articular corticosteroid reduces joint stiffness after an experimental periarticular fracture. The Journal of Hand Surgery. 1992. DOI: 10.1016/s0363-5023(09)91083-8

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

[42] 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

[43] Comparison of the effectiveness of platelet-rich plasma (PRP) injection and steroid injection in patients with bilateral moderate carpal tunnel syndrome: a prospective randomized controlled trial. Injury. 2026. DOI: 10.1016/j.injury.2026.113018

[44] 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

[45] 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

[46] X-ray Guided Steroid Injections for Proximal Interphalangeal Joint Osteoarthritis of the Fingers. The Journal of Hand Surgery (Asian-Pacific Volume). 2017. DOI: 10.1142/s0218810417500277

[47] Treatment of Distal Interphalangeal Ganglion Cysts by Volar Corticosteroid Injection. HAND. 2017. DOI: 10.1177/1558944717744336

[48] The safety and cost of repeated corticosteroid injections for carpal tunnel syndrome. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934251396629

[49] Effectiveness of Corticosteroid Injections in Diabetic Patients With De Quervain Tenosynovitis. The Journal of Hand Surgery. 2022. DOI: 10.1016/j.jhsa.2022.02.018

[50] Time to Resolution of Triggering after Steroid Injection for First Presentation Trigger Digits. The Journal of Hand Surgery (Asian-Pacific Volume). 2020. DOI: 10.1142/s2424835520500253

[51] Factors Influencing the Successful Treatment of Recurrent Trigger Finger With Repeated Corticosteroid Injections: A Prospective Cohort Study. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.12.002

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