The shoulder is prone to different kinds of injuries and inflammatory conditions. An shoulder injection is a minimally invasive procedure to treat pain and improve shoulder movement. It may be performed in the office setting or sometimes with the help of ultrasound or fluoroscopic imaging which allows the radiologist to precisely target the space involved.
Anatomy
The shoulder consists of two joints. The main joint is the glenohumeral joint formed by the head of the upper arm bone or humerus and the glenoid cavity at the side of the shoulder blade. The acromioclavicular joint of the shoulder is formed by the clavicle or collar bone and the acromion, a bony projection of the shoulder blade. The shoulder is supported by muscles, tendons, and ligaments. A rotator cuff is a group of 4 muscles that provide stability to the shoulder and enable arm movements in various directions. A fluid-filled sac called the bursa is present between the muscles and bones to provide lubrication for smooth shoulder movements. The bursa is another space that is commonly targeted with injections.
Shoulder injections are used for both diagnostic (helping to understand where pain is coming from) as well as therapeutic (treating the condition) purposes. Corticosteroids are the most commonly injected medications to relieve pain and inflammation or improve lubrication in the joint.
Indications
Some of the common indications for shoulder injections include:
- Arthritis
- Frozen shoulder
- Rotator cuff injuries
- Impingement syndrome
- Tendonitis
- Ligament injuries and Bursitis
Your doctor may recommend a shoulder injection if your symptoms are not relieved by conservative treatments such as oral medications, activity modification, and physical therapy.
Procedure
The administration of the injection depends upon the condition to be treated. Your doctor may inject the subacromial bursa, the glenohumeral joint or the acromioclavicular joint.
The bursa and glenohumeral joint are usually approached from the back of the shoulder.
Postinjection Care
- You should avoid strenuous activities involving the injected area for at least 2 days, and continue to avoid activities that you know have aggravated the shoulder for at least 6 weeks. Otherwise, you can continue to use the arm as normal.
- You may experience worsening symptoms initially in the first few days which can be treated with ice and medications.
- Your doctor will see you in about 2 months to check on your progress.
Risks and Complications
shoulder injections are a relatively safe procedure. However, it may rarely be associated with certain risks and complications such as:
- Septic arthritis
- Bleeding at the site of insertion
- Injury to adjacent structures
- Pain and swelling
- Infection
- Allergic reaction