Injections for shoulder pain
Why is shoulder pain so common?
Shoulder complaints are a very common complaint with a lifetime prevalence of up to 70%. Injections for shoulder pain can be an effective treatment option in many cases.
The shoulder is the most mobile joint in the body which delivers incredible function. Think about the positions you can get your arm into and the power that it can deliver! It relies on the co-ordinated action of many muscles around the shoulder complex to provide stability and power which are very important features for normal arm function. When something goes wrong, this delicate balance is disrupted and this can lead to pain, loss of power and reduced mobility. Because the use of our arm is so important in day to life – our work, recreation, hobbies and sport – any loss if function is quickly noticed.
What are the common causes of shoulder pain?
Frozen shoulder is the common name used for a condition called adhesive capsulitis which causes pain and limitation of shoulder movement. The tissues around the shoulder (capsule) become inflamed (itis) in response to injury and become thicker and tighter and this limits movement. It is a very painful and limiting condition which can take 6-18 months to resolve. The condition is more likely if you are between the ages of 40-60 and is more common in women. It is definately better to get early treatment for this condition and a joint injection with physiotherapy treatment is the way to achieve the fastest recovery. You can find out more in this helpful video from one of our partner clinicians Professor Len Funk below.
Sub-acromial pain syndrome (SAPS) is an umbrella term used to describe a broad collection of conditions at the shoulder such as impingement, calcific tendinitis, bursitis and rotator cuff injury. Pain coming from the sub-acromial area is the most common cause of shoulder pain accounting for up to 65% of all shoulder complaints, more commonly presenting in the older adult. The rotator cuff tendons are often at fault (through injury or ‘wear and tear’) and need careful rehabilitation to recover satisfactory function. A cortisone injection is sometimes needed to reduce pain to facilitate this process.
The acromioclavicular joint is a small joint on top of the shoulder which is prone to dislocation in the younger patient and arthritis in the older population. It commonly presents alongside SAPS and so the condition often needs to be treated in tandem with this. Injection of the ACJ is an effective tool to reduce pain and inflammation in order to facilitate physiotherapy treatment.
Instability of the shoulder can be caused by injury (labral injury – SLAP or Bankart injury) or overuse injuries to the rotator cuff. If severe enough surgery may be indicated but in most cases these injuries are treated most effectively with physiotherapy and rehabilitation.
Why injections should always go hand in hand with expert physiotherapy
Cortisone injections for shoulder pain are geared to do just that – reduce pain. Recovery from shoulder pain always requires expert physiotherapy to restore movement or strengthening key muscles needed for normal function. The problem is that pain gets in the way of effective exercise and treatment locking people into long term disability. The pain relief provided by the injection can create an opportunity for effective hands-on treatment and exercise therapy to address the key mechanical factors that have caused the problem in the first place. It is vital that this rehabilitation is not missed out as without addressing the cause, the pain relief from the injection will be temporary and the problem will return. No injection should ever be done in isolation if an optimum outcome is desired.
Should I be having an ultrasound guided injection?
Ultrasound guided injections for shoulder pain are considered to be ‘gold standard’ to achieve maximum accuracy and effectiveness. It allows the clinician to guide the needle to the exact site of the problem but in some cases anatomical (or landmark) guided injections are selected.
What are Hyaluronic acid injections?
Whilst the anti-inflammatory effects of cortisone injections are commonly needed to reduce pain, Hyaluronic acid injections are increasingly playing an important role in helping to restore normal conditions within the joint, improving movement and reducing pain.
Is the pain coming from my neck or shoulder?
Pain that comes from the shoulder usually produces pain around the shoulder itself and down the upper arm. It will only cause pain below the elbow when the shoulder is very irritated. If you are experiencing pain to the side of the neck towards your shoulder joint, the likely source of the pain is from the spine. We will always screen your neck and shoulder to ensure the true source of the pain.