Vibratory Anesthesia on Pain Following Corticosteroid Injections

Purpose

This research study aims to evaluate injectional pain at the site of needle insertion for corticosteroid injections (CSI) of the upper extremity depending on different modes of anesthetics. Each individual's perception of pain upon receiving a CSI with two out of three modes of anesthesia (control/no anesthesia, vibrational anesthesia, vapo-coolant anesthesia) will be utilized to compare these variables and determine the method that is associated with the least pain.

Conditions

  • Bilateral Arthritis of Wrist
  • Tendinopathy
  • Arthropathy
  • Compression Neuropathy
  • Bilateral Arthritis of Hands

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Any patient of the Principal Investigator, Dr. John Faillace, who has clinically diagnosed bilateral arthritis, tendinopathy, arthropathy, or compression neuropathy of the hand, wrist, or elbow where treatment with corticosteroid injection is indicated. - Participants who voluntarily consent to participate in the study and sign consent forms. - Participants who complete all numeric pain rating scales - Patients aged ≥ 18 years old

Exclusion Criteria

  • Participants who opt out of the study or withdraw consent - Participants who are determined to be without capacity to consent to study participation or injection procedure by principal investigator - Participants with inability to complete numeric pain rating scales - Participants with known allergies to triamcinolone acetonide, lidocaine, or bupivicaine - Participants without clinically diagnosed bilateral arthritis, tendinopathy, arthropathy, or compression neuropathy of the hand, wrist, or elbow. - Participants where treatment with corticosteroid injection is not indicated bilaterally. - Patients ≤ 18 years old

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Supportive Care
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
No Intervention
Arm 1
No anesthesia and vapocoolant spray topical anesthetic prior to injection. Participant will complete post-injection numeric pain rating scale assessing pain of injection.
Experimental
Arm 2
Limb A: no anesthesia and Limb B:vibration anesthesia using the Digivibe device throughout the duration of the injection. Vibratory anesthesia will be administered throughout the duration of the injection. The circular part of the device will be applied directly to the surface of the skin. At the center of the circle is where the injection will be given, and the vibration will be turned on throughout the duration of the injection. After typical disposal of injection syringe, participant will complete post-injection numeric pain rating scale assessing pain of injection.
  • Device: Digivibe Device
    The Digivibe device uses pulsed vibrations to activate larger nerve fibers to inferfere with pain signals. It has a circular shape to allow for injections in an area surrounded by pain-blocking vibrations.
Experimental
Arm 3
Limb A: vapocoolant spray topical anesthetic prior to injection and Limb B: vibration anesthesia using the Digivibe device throughout the duration of the injection Vapocoolant spray anesthesia will be applied until the skin blanches, which is the standard clinical use. Corticosteroid injection will be given. After typical disposal of injection syringe, participant will complete post-injection numeric rating score.
  • Device: Digivibe Device
    The Digivibe device uses pulsed vibrations to activate larger nerve fibers to inferfere with pain signals. It has a circular shape to allow for injections in an area surrounded by pain-blocking vibrations.

Recruiting Locations

University of Texas Medical Branch
Galveston, Texas 77555
Contact:
Alice Lee
409-772-1011
alklee@utmb.edu

More Details

Status
Recruiting
Sponsor
The University of Texas Medical Branch, Galveston

Study Contact

John Faillace, MD,FAAOS
409-772-1011
jofailla@utmb.edu

Detailed Description

As part of standard medical care, participants receive corticosteroid injections to the bilateral upper extremities. Following written informed consent, participants undergo the study procedures described below. Each participant receives a total of two injections, with one injection administered in each arm during a single study visit. The type of anesthesia used for each injection is determined by random assignment using a computer-generated randomization sequence within the REDCap system. Participants are assigned to one of the following anesthesia combinations: No anesthesia and vapocoolant spray topical anesthetic applied prior to injection No anesthesia and vibration anesthesia using the DigiVibe device throughout the duration of the injection Vapocoolant spray topical anesthetic applied prior to injection combined with vibration anesthesia using the DigiVibe device throughout the duration of the injection For participants assigned to a DigiVibe group, the device is applied directly to the skin. The device contains a circular component that contacts the skin surface and provides vibratory stimulation. The injection is administered within the circular area while vibration is applied. Upon completion of each injection, participants complete a numeric pain rating scale to assess perceived pain and comfort associated with the anesthesia method used. Both corticosteroid injections are administered as part of routine clinical care. The use of topical anesthetic and/or vibratory anesthesia is performed solely for research purposes. The total duration of the study visit is approximately 20 minutes.