Techniques of Shoulder Joint Injections & Their Benefits

Multiple shoulder injuries and inflammatory conditions can be diagnosed and treated with injections. Get shoulder joint injections after trying nonsteroidal anti-inflammatory drugs, physical therapy, and activity modification. Glenohumeral joint injections are for osteoarthritis, adhesive capsulitis, and rheumatoid arthritis. Injections can diagnose and treat acromioclavicular osteoarthritis and distal clavicular osteolysis. Subacromial injections treat adhesive capsulitis, subdeltoid bursitis, impingement syndrome, and rotator cuff pain. Scapulothoracic injections only treat bursa inflammation. Injections in the long head of the biceps relieve inflammatory pain. Effective results require proper technique, drug selection, and follow-up. 

Therapeutic Shoulder Joint Injections

Cortisone and viscosupplementation can relieve shoulder arthritis pain, but the latter is experimental. 

Cortisone 

Cortisone shots are the first. They may reduce joint inflammation. Cortisone is usually mixed with a numbing agent for immediate pain relief. It also checks the injection's placement for pain management physicians. After the numbing medicine wears off, the joint may hurt until the cortisone kicks in. Cortisone shots don't harm the shoulder, but most surgeons limit them to a few per year for arthritis. Certain medical conditions require caution with cortisone. Diabetes patients may experience a temporary rise in blood sugar after a cortisone injection. 

Viscosupplementation 

Shoulder arthritis can be treated with viscosupplementation, synthetic hyaluronic acid or joint fluid derivatives. This liquid substance has been injected into arthritic knees for years, but it is still an experimental shoulder treatment, and most insurance companies don't cover it. Small amounts of synovial fluid are in the shoulder joint. This fluid lubricates and cushions joints. Hyaluronic acid makes synovial fluid viscous. Thin synovial fluid reduces lubrication. Pain management clinics near me can inject lab-produced hyaluronic acid into the shoulder joint's synovial fluid to increase its viscosity and improve its gliding motion. Improved joint function may relieve pain for weeks or months. Best doctor for shoulder pain near me recommends one hyaluronic injection per year. 

What Are Shoulder Steroid Injection Benefits?

The primary advantages of steroids injections are:

• Pain relief is a major benefit of shoulder steroid injections. These injections reduce shoulder joint inflammation, relieving pain from rotator cuff tendinitis, bursitis, and arthritis.

• Steroid injections done by shoulder physio near me reduce shoulder swelling and stiffness and relieve pain. This improves shoulder mobility and range of motion.

• Non-invasive choice: Steroid injections are less invasive and safer than surgery for shoulder pain.

• Quick results: Many shoulder steroid injections provide immediate shoulder injury pain relief that lasts weeks to months.

How Effective Are Shoulder Steroid Injections?

In frozen shoulders and other shoulder conditions, shoulder joint injections can relieve pain and improve shoulder function. These injections may work depending on the shoulder pain's cause, the patient's health, and other factors. Rotator cuff tendonitis patients benefit from corticosteroid injections for pain relief and function. Many patients find relief from shoulder steroid injections, but the effects are usually temporary. Repeat injections may be needed to maintain pain relief.

Techniques for Shoulder Injection

Shoulder joint injections diagnose and treat, Injections include corticosteroids and hyaluronans.  Anti-inflammatory corticosteroids reduce swelling and inflammation. These are often used with physiotherapy and other medications to treat subacromial impingement syndrome, AC joint pathology, and inflammatory arthritides more effectively. Hyaluronans coat pain receptors, stimulate synovial fluid production, and lubricate. They may help treat degenerative synovial joint disease without surgery. 

Injection of Glenohumeral

Used by a shoulder pain doctor in Dallas to relieve shoulder arthritis and frozen shoulder pain. 

Posterior Approach

The patient sits with their arm at their side and shoulder in neutral rotation on their lap. The humerus head-acromion sulcus is identified. The needle is inserted 2-3 cm below and medially to the acromion's posterolateral corner and directed anteriorly to the coracoid process. In the glenohumeral joint, an 18-gauge needle should sink completely, and the plunger should push easily and without resistance. 

Anterior Approach

Insert the needle medial to the humerus head, 1 cm lateral to the coracoid process, and posteriorly at a slight superior and lateral angle. Another 18-gauge needle should easily enter the joint and inject without resistance.

Injection of Subacromial 

Used to relieve subacromial, rotator cuff, and tendinosis pain. As shown, the patient sits with their arm by their side. The posterior edge of the acromion is identified, then the needle is inserted inferior to the posterolateral acromion and directed laterally into the subacromial space to the anterolateral corner. The long 18-gauge needle should be 2-3 cm anterior to the posterolateral corner of the acromion, and the syringe plunger should push easily during injection. The common mistake is to inject into the rotator cuff, so draw and reposition the needle higher under the acromion if resistance occurs. Corticosteroids are proteolytic, so avoid this. 

Injection of Acromion 

This injection is used by shoulder injury doctors for distal clavicle osteolysis and joint osteoarthritis pain relief. The patient sits with their arm at their side. The needle is inserted from an anterior and superior angle and directed inferiorly after palpating the distal clavicle to find the AC joint convexity where it meets the acromion. The needle should be directed medially to account for the angled AC joint in over half the population. The needle should effortlessly penetrate the joint to administer 2 ml. This joint has a maximum capacity of 2 ml.

Injection of LHB

Used to relieve biceps tendonitis pain in the long head. The needle cannot 'feel' the biceps tendon deep under the thick deltoid, so ultrasound guidance is recommended.

Proteolytic steroid injections into the biceps tendon can also rupture it. Hyaluronans (Ostenil) are preferred for young patients. Since the humeral version varies greatly, the tendon position can only be determined by rotating the arm into the best injection position and letting the patient rest it. An LHB tendon and groove marker is applied to the skin. The injection site is marked lateral to the ultrasound probe. The needle points 45 degrees toward the LHB sheath and tendon in the probe's long axis. Instead of the tendon, the swollen sheath is injected. Injected fluid enters the sheath.

Conclusion