Shoulder Joint Injections
Steroid and Local Anesthetic
Injections to the Shoulder Joint
Steroid injections are useful tools in the management of chronic shoulder pain. We typically use an anterior or a posterior approach to place the steroid in the joint. The injection consists of local anesthetic and cortisone, either separately or mixed together. It is important to note the effect of each of these substances. The local anesthetic will usually commence its effect after a few minutes and last from between 20 minutes to 4 hours. The cortisone usually will take effect between 48 hours to a week. The steroids act as anti-inflammatory agents and reduce the shoulder pain and swelling. This becomes important when arthritis or bursitis is a cause of the pain. Typically, physical therapy is started after the injection. The injection is helpful for arthritis of the shoulder joint and bursitis
Although there is no limit to the amount of times that the shoulder joint can be injected with cortisone, the typical recommendation is no more than three times per year. There are several choices of steroid that can be used depending on physician preference. These include Kenalog, Depo-Medrol, and Celestone.
Cortisone injections into the shoulder are seldom dangerous and have little effect on other body functions. Patients with diabetes must be aware that such an injection can temporarily elevate their blood sugar. Complications include infection and bleeding into the joint if the needle goes through a significant blood vessel.
PRP (Platelet Rich Plasma) Injections
PRP and or Stem Cell injections into the shoulder joint may facilitate the healing and regenerative process following a shoulder injury. Platelet Rich Plasma is obtained from the patient’s own blood, placed in a Harvest Centrifuge, and separated into platelets, plasma, and blood cells. A small portion of the plasma is mixed with the platelets and this combination is injected into the shoulder joint with a syringe and needle. Stem cells are obtained from the posterior superior iliac crest of the hip and placed in a Harvest Centrifuge and separated to obtain only the platelets and stem cells. This is usually done under fluoroscopy for proper placement of the PRP or Stem Cells. Most of the usage of PRP has been with sports injuries. The products accelerates the rate of soft tissue and bone healing following injury. You should consider PRP or Stem Cells for rotator cuff tears and tendinopathies. Many athletes use PRP and Stem Cells to speed recovery and repair partial rotator cuff tears and labrial tears.