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Shoulder injections are used for diagnostic, as well as therapeutic purposes. The common substances injected include corticosteroids and hyaluronans.

Corticosteroids are strong anti-inflammatory medications reducing swelling and inflammation. These are often used in conjunction with physiotherapy rehabilitation and other medications for a more lasting cure of many conditions, such as subacromial impingement syndrome, AC joint pathology and inflammatory arthritides.

Hyaluronans also have anti-inflammatory benefits, as well as coating pain receptors, stimulating endogenous synovial fluid production and lubrication effects. They seem to have a role in degenerative synovial joint disease.

Injections are often performed with image guidance.. Image guided injections are more accurate, but also require a skilled clinician who is familiar with the technique and equipment.

Used for pain relief of shoulder arthritis and frozen shoulder affecting the shoulder.

Used for pain relief of subacromial impingement

Used for pain relief of biceps tendonitis

A suprascapular nerve block can provide relief to individuals suffering from acute or chronic shoulder pain.

Suprascapular nerve block or Pulsed radiofrequency are day case procedures which can be performed with an anatomical landmark technique or ultrasound guidance. This will take place in theatre under full aseptic conditions with the patient sitting or in a semi-reclined position. A small needle in the back of your hand can be used to administer sedation or in case of an emergency. The skin is well cleaned before a small amount of local anaesthetic is applied in order to numb the injection area. The physician then directs a small needle to the nerve. A small mixture of steroid (anti-inflammatory medication) and anaesthetic is then injected into the nerve.

Pulsed radiofrequency is a relatively new treatment for shoulder pain which uses neurostimulation therapy in order to modulate the function of the nerve. Pain signals to the brain are interrupted by an electrical pulse, meaning the patient does not feel the same pain as he or she did previously. This may be indicated if there is a significant reduction in the pain levels after the suprascapular nerve block to prolong the benefit. This procedure can be described as a ‘retuning’ of the nerves so that they modulate pain transmission.

Patients are then monitored in a recovery area before transfer to the ward and discharge home. Patients may experience a numb feeling for a few hours. Pain at the injection site may increase for four or more days. It is advisable to rest for 24 hours and resume stretches and exercises when the pain eases. This window of pain relief should be utilised for performance of strengthening exercises and rehabilitation physiotherapy.