Shoulder pain can result from a range of injuries, diseases and medical conditions affecting the joint or the surrounding muscles, tendons and ligaments.
For many patients suffering with painful shoulder injuries and chronic conditions, guided injections can provide symptom relief and long-term healing.
Guided injections are more accurate and effective — and less painful — than traditional injection treatments. Corticosteroids and hyaluronic acids have been commonly used, but guided platelet-rich plasma (PRP) and bone marrow-derived stem cell injections show great promise in treating patients with painful shoulder problems.
What Are Guided Injections?
Doctors rely on their understanding of the anatomical structures of the shoulder for traditional injection treatment. Manipulating the joint and feeling the soft tissues allows for an educated guess as to the proper placement for an injection.
But with guided injections, no guesswork is involved. An ultrasound machine uses painless, high-frequency sound waves to provide a clear picture of the tissues inside the shoulder. Essentially, the ultrasound allows the orthopedic doctor to see into the joint.
Live fluoroscopic (X-ray) technology may also be used to guide the treatments, depending on the location of the injury.
What Are the Advantages of Guided Injections?
Five joint areas are responsible for shoulder function — the glenohumeral, acromioclavicular and sternoclavicular joints; the subacromial space; and the scapulothoracic gliding mechanism. These are all surrounded by an elaborate system of muscles, ligaments and tendons.
Injections of corticosteroids, hyaluronic acid, platelet-rich plasma or stem cells must be precisely placed in order to help manage painful shoulder problems. With ultrasound guidance, doctors are able to achieve higher accuracy, ensuring that the injected solution goes exactly where it needs to go.
Guided injections are also easier for patients than traditional injections. Because the doctor can see exactly where to place the injection, the procedure is quicker and less painful.
Are Guided Injections the Best Solution for Shoulder Pain?
The right treatment for shoulder pain depends on the cause, and no single solution is appropriate for everyone.
Other conservative measures such as resting the joint, applying ice or heat, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and having physical therapy are often first recommended for the treatment of shoulder pain. If those approaches fail, however, orthopedic specialists often turn to guided injections, as the treatment is quick, noninvasive and provides fast pain relief.
Ultrasound or fluoroscopic guided injections are not a cure-all, but they can be useful for managing many painful conditions, including osteoarthritis, rheumatoid arthritis, bursitis, rotator cuff tendinosis and shoulder impingement. For patients whose symptoms don’t respond to corticosteroid or hyaluronic acid injections, or to other conservative treatment options, platelet-rich plasma or stem cell injections can be a safer, more effective alternative to surgical treatment.
For nonresponsive persistent shoulder pain or severe injuries — recurring dislocations or rotator cuff tears, for example — arthroscopic or open shoulder surgery may be explored. Whenever possible, however, orthopedic and sports medicine specialists seek nonsurgical options for treating chronic shoulder pain.