SHOULDER
Shoulder pain is a common problem that can be caused by a variety of factors including a tear in a tendon of the rotator cuff, a tear of the labrum, arthritis of the glenohumeral joint (ball and socket), arthritis of the acromioclavicular, inflammation of the tendon or bursa and frozen shoulder. Cortisone injections are a common treatment option for shoulder pain.
What is a cortisone injection?
Cortisone is a type of steroid that has anti-inflammatory properties. When injected into the shoulder, cortisone can help to reduce inflammation and pain.
How do cortisone injections work?
Cortisone injections work by reducing inflammation. Inflammation is the body's natural response to injury. It causes the release of chemicals that can cause pain, swelling, and redness. Cortisone injections can help to block the release of these chemicals, which can lead to a reduction in pain and inflammation.
How long do cortisone injections last?
The effects of cortisone injections can last for several weeks or months. However, the effects are not permanent, and the pain may return after the medication wears off, especially if there is a structural problem in the shoulder.
What are the risks of cortisone injections?
Cortisone injections have some potential risks however they are small risks if the shot is done correctly and for the right reasons. These risks include:
• Pain at the injection site
• Bruising
• Skin discoloration
• Infection
• Weakening of rotator cuff tendons
• Increased risk of infection if joint replacement surgery is performed on the same joint within 3 months
How does Dr. Howlett's team use cortisone injections in the shoulder?
There are 4 main areas in the shoulder that can be targeted for injection:
• The subacromial space around the rotator cuff
• The biceps tendon sheath
• The glenohumeral joint
• The acromioclavicular joint
Depending on your clinical exam, our orthopedic providers will often offer an injection into one of these areas for both diagnostic and therapeutic purposes. The diagnostic purpose is to help us isolate the troubled spot, and the therapeutic purpose is to help you get better.
How many cortisone injections can I get?
Not many! Because cortisone can weaken the tendons of the rotator cuff if given too much. Generally, our team usually tries to define and treat the underlying problem to get rid of your shoulder pain for good. However, there is a small set of patients who have severe shoulder arthritis, a known irreparable rotator cuff, or medically cannot undergo surgery, who may be good candidates for more than one cortisone shot if it is effective for them.
Will a cortisone injection fix my rotator cuff tear?
The short answer is no. If you have a true rotator cuff tear, the only way we currently can definitively fix it today is to surgically repair the tendon back to bone. There are biologic strategies such as platelet rich plasma which aim to put growth factors in or near the tendon to promote healing, but the data showing that it works is still being researched.
What can I expect after an injection?
Most people may feel immediate relief since the cortisone injection includes a mixture of lidocaine (a quick acting numbing agent). If put in the right place, you may feel better right away. However, there are some patients who end up getting some rebound pain the next day. This is usually temporary and improves over the course of 24 to 48 hours.
What if my cortisone injection works initially but then wears off quickly?
At this point, if you have had an injection and coupled this with either physical therapy or a home exercise program, Dr. Howlett's team will likely recommend an MRI to see what structure in the shoulder may be injured and hence why your pain is coming back.
How do I schedule an appointment to see Dr. Howlett's team to discuss this further?
We have many of great shoulder surgeons at Ortho Rhode Island and we are happy to get you in to see someone on Dr. Howlett's team or one of his colleagues by calling our main number at 401-777-7000. See you soon!
