The shoulder is a common joint to be injured and also inflamed. Joint injection with a long-acting steroid and local anaesthetic is often an extremely successful treatment for disorders of the shoulder joint and capsule.
The shoulder joint injection should be considered if other treatments such as physiotherapy and pain relief with NSAIDs have been tried.
Osteoarthritis of the shoulder typically occurs in older people or, in younger people following an injury. The individual will usually complain of chronic pain, decreased range of motion, and accompanying weakness. Although XRays may assist in the diagnosis, the findings do not always correlate with clinical symptoms or functioning. Ultrasound scanning is a better method of visualising the ‘soft-tissues’ around the shoulder joint.
Adhesive capsulitis or frozen shoulder is a condition typically occurring in middle-aged and older adults, It is usually associated with an injury or non-use of the shoulder secondary to pain, discomfort, or prolonged immobilization. It may occur after a heart attack and is more common in women and people with diabetes. There is often accompanying tendon inflammation or bursitis. Rheumatoid arthritis is an autoimmune joint disease that involves inflammation of the joint lining (synovium). The shoulder may be involved, but more usually, rheumatoid affects the hand and wrist joints.
When there is osteoarthritis of the shoulder joint, the physician may find painful and decreased range of motion, generalized weakness and a ‘crunchiness’ with shoulder movement.
The joint injection is a simple procedure which can be done in the doctor’s consulting room. The procedure will be explained to the patient, the skin at the back of the shoulder is cleaned with alcohol swab, the skin sprayed with a numbing ‘freezing agent’ (ethyl chloride) and then the joint injected with a fine needle with a combination of the steroid and local anaesthetic. It should be a relatively painless procedure, over in seconds. Occasionally the accuracy of the injection can be improved by performing the procedure using ultrasound guidance. This can be done on the spot at our Harley Street consulting rooms.
The steroid used is usually triamcinolone or depo-methyl prednisolone. The procedure is safe and complications are extremely rare. Occasionally there is slight pain for the first 24hours after the procedure. This is dealt with using simple pain relief. This then settles. The benefit may take up to 2 weeks to fully take effect.