Knee Injections: Disctrpancies between Pre and Post Injection Pain Anxiety

Background:
Fear of injections is probably more common than reported and may have impact with treatment compliance. Intra-articular knee injections may be performed as a treatment option or as a diagnostic tool. To our knowledge, the gap between anticipated and experienced pain of intra articular knee injections was not investigated.

Study Design: Cohort study; Level of evidence, 3.

Methods:
This study included 29 patients who underwent intra articular knee injection by orthopedic specialists in the outpatient clinic. Patients recruited to the study filled a questionnaire regarding anticipated and experienced pain, and factors that might influence the patient fear of injections.

Results:
There was a significant difference between estimated VAS score (mean VAS 6.69) and experienced VAS score regardless of gender (mean VAS score 2.17, p value <0.001). There was a significant difference between males to females in terms of estimated VAS score (male:female mean VAS score 6.0:8.22, p value 0.032) and the difference between estimated and experienced VAS scores (delta) (male:female mean VAS score 3.70:6.33, p value 0.012). There was no significant difference in experienced VAS score in term of gender (male:female mean VAS score 2.30:1.89, p value 0.601).

Conclusions:
A significant difference was found between anticipated and experienced pain from intra articular knee injections. There was difference in anticipated pain and delta in term of gender. Our study may help to reduce the gap between expected and actual pain level experienced by the patient and therefore facilitate evidence-based consultation that may reduce fear of knee injections.