The advent of injectable insoluble corticosteroids in 1952 allowed steroid injected at tender spots to remain long enough to destroy affected tissue and allow regrowth of normal fibres. Injection of small doses of triamcinolone and lignocaine directly into trigger points has proved a success in relieving chronic pain associated with localised fibromyalgic lesions in 70% of the author’s personal series of 840 patients. Each steroid injection given in this series has been recorded with a diagram of its exact position. This has shown that recurrence of pain is very rarely associated with recurrence of tenderness at the injected trigger point, and that injection of other tender points nearby is likely to prove effective.
Intra-articular corticosteroid injection is reported as providing poor pain relief in arthritic disease except when there is seepage out of the joint space into the synovium and periarticular ligaments, but intra-synovial injection gives consistent local symptomatic relief.
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