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Related Experiment Videos

Tender shins and steroid therapy.

H A Smythe1, D Lee, P Rush

  • 1University of Toronto Rheumatic Disease Unit, ON, Canada.

The Journal of Rheumatology
|October 1, 1991
PubMed
Summary

Chronic steroid therapy increases shin tenderness, with a lower pain threshold observed in treated patients compared to controls. General tenderness increases were also noted in patients with lupus and in women.

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Pain Medicine

Background:

  • Chronic steroid therapy is associated with various side effects.
  • Shin tenderness has been anecdotally reported in patients on long-term corticosteroids.
  • Objective quantification of this tenderness is lacking.

Purpose of the Study:

  • To objectively quantify shin tenderness in patients receiving chronic steroid therapy.
  • To differentiate site-specific tenderness from general hypersensitivity.

Main Methods:

  • Dolorimetry was used to measure tenderness thresholds at shin, control, and "fibrositic" sites.
  • 54 patients were studied: 26 on chronic steroid therapy and 28 controls.
  • Observer variation was assessed by multiple observers.

Main Results:

  • Patients on steroid therapy showed significantly increased tenderness at shin sites (mean threshold 3.0 kg vs. 5.6 kg in controls).
  • Steroid therapy also led to a general increase in tenderness at control sites (2.0 kg increase).
  • Increased tenderness, independent of steroid therapy, was observed in patients with lupus and in women.

Conclusions:

  • Chronic steroid use specifically increases shin tenderness.
  • Steroid therapy induces a generalized increase in pain sensitivity.
  • Underlying mechanisms for steroid-induced tenderness may be both site-specific and systemic.

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