Intraarticular corticosteroid injections: should we rest the joints?

To prevent damage in injected joints, it has been our policy to rest them for 48 hours. To test this assertion we randomized 30 rheumatoid arthritis (RA) patients (rest, no-rest). Results in 28 patients (63 joints: 27 rest and 36 no-rest) are presented. Joint evaluation was performed at baseline and at 48 hours (pain/tenderness, swelling and range of motion). Two analyses were conducted, the first included all joints, and the second only joint pairs. In both cases measurements at 48 hours were comparable for the rest and no rest group for both upper and lower extremity joints (pain/tenderness/swelling and range of motion). At a later follow up (average 10 months) there were no differences in any of the parameters examined. Our study suggests that rest is not essential for intraarticular corticosteroids to be beneficial, at least in an inpatient setting. The applicability of our data to an outpatient population remains to be determined.