article · SVOA Medical Research
Sickle cell disease is often linked with severe joint pain, or arthropathy, which frequently requires periarticular injections. Standard steroid injections, such as dexamethasone, can carry health risks for these individuals, prompting interest in alternatives. A study of twenty adult patients with severe knee or hip arthropathy compared periarticular magnesium injections against dexamethasone injections across matched groups of sickle cell disease patients and non-affected individuals. Before treatment, all participants reported high pain levels alongside restricted sleep and mobility. Both magnesium and dexamethasone produced comparable therapeutic improvements across pain, sleep quality, and walking ability in both patient groups. However, dexamethasone led to a sickle cell crisis in one patient and insomnia in another. In contrast, magnesium injections produced no observed complications, indicating that magnesium is an effective, safer substitute when steroid avoidance is needed.
Managing joint pain in sickle cell disease is challenging because conventional steroid treatments can trigger severe disease complications. Demonstrating that magnesium injections offer equal pain relief and mobility improvements without triggering adverse events offers a safer treatment pathway for patients who cannot tolerate steroids, helping improve quality of life and physical functioning.
This research highlights a clinical application for magnesium formulations as alternatives to steroid injections for joint pain management in sickle cell disease. Potential users include hospital pain clinics, rheumatologists, and haematologists managing arthropathy. Because the treatment relies on established, accessible compounds evaluated directly in an applied clinical setting with twenty patients, it reflects early applied clinical research that requires broader clinical trials to establish formal therapeutic protocols.
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Background: Sickle cell disease (SCD) is associated with arthropathy. Arthropathy pain may require periarticular injection therapy. However, steroid injections may be unsuitable for SCD patients. Alternatively, magnesium injection may provide analgesia and avoid steroid requirement. This is a study of the impact of periarticular injection therapy on pain, sleep, and walking function improvement in SCD. It studied periarticular magnesium injection versus periarticular dexamethasone injection in SCD and matched non-SCD patients. Methods: This is an observational study of twenty adults with severe arthropathy. Data collected included patients’ pain score, walking function score, sleep score, and periarticular injection therapy outcomes. Walking ability was assessed using the arthritis self-efficacy scale of 10-100. Pain was measured using the 10-point numeric scale. Sleep was assessed using the 10-point Likert scale. Results: Ten consecutive SCD patients were matched with ten non-SCD patients with similar clinical characteristics. Eleven patients had knee arthropathy, and nine patients had hip arthropathy. Twelve patients used codeine analgesic, and eight patients used tramadol analgesic regularly. The patients’ pre-treatment numeric pain scores were 7-9, Likert sleep scores were 2-4, and walking function scores were 20-30. Periarticular magnesium or dexamethasone injections produced similar improvements in the walking function, pain, and sleep scores of the SCD and non-SCD patients. One SCD patient developed a sickle cell crisis after a dexamethasone injection. One non-SCD patient experienced insomnia after dexamethasone injection. Magnesium injection was not associated with any complications. Conclusion: SCD arthropathy pain is severe. Periarticular magnesium injection provides safe and effective analgesia for SCD arthropathy. Periarticular dexamethasone injection may be employed in SCD patients with no hypothermia, infection, or immunocompromise. Magnesium injection is a better and safer alternative in clinical situations that require steroid avoidance. Periarticular magnesium injection therapy promotes value-based healthcare for SCD arthropathy patients.
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DOI: 10.58624/svoamr.2025.03.010
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