Many patients contact us asking with regard to corticosteroid injections for shoulder bursitis. There are several bursae around the shoulder. The subacromial subdeltoid bursa, also known as subacromial bursa, is the one, which is most often diagnosed as being inflamed and painful.
Bursitis can be acute – The result of a direct trauma, or a sudden increase in activity.
It can also be chronic – A constant irritation or a longstanding impingement of a bursa, can cause thickening and effusion in the bursa.
Bursitis can also occur due to a tear within one of the rotator cuff tendons. Therefore, before injecting a bursa, one should always perform investigation imaging, such as an ultrasound.
At Complete Physio we are able to assess the shoulder and perform ultrasound to advise you of this, as well as potentially performing an ultrasound guided injection.
What is a bursa?
Usually found at the interface between tendons and muscle, tendon and bone, a bursa is a small soft tissue ‘sac’. They have a number of functions. One is a type of cushioning and protection to reduce irritation and inflammation and stress on adjacent structures when moving or when susceptible to impact. However, unfortunately, they can themselves become inflamed and when they do they are very painful.
What is bursitis?
Bursitis is the term we use when the bursa is inflamed or irritated. The bursa may be expanded by fluid within the bursa. Often it will appear thickened. We can view this using ultrasound.
How do steroid injections work for inflamed bursae?
Under ultrasound guidance, the anti-inflammatory Glucocorticosteroid, is given directly into the bursa. The results have a fast acting effect, significantly reducing pain, irritation and inflammation of the bursa. The purpose of this is to then allow you to rehabilitate the shoulder.
Invariably, after an episode of shoulder pain the muscles become weak. We therefore highly recommend a program of physiotherapy, after treatment. Physiotherapy can help bring the shoulder back to full strength and flexibility therefore reducing the risk of any recurrence.
Are injections for shoulder bursa painful?
Injections into the shoulder bursa are actually very superficial injections and performed with a very fine needle. Therefore, patients often find them comfortable and generally with minimal amount of pain.
Do shoulder bursa injections hurt after the injection?
We usually use a combination of steroid and local anaesthetic. The local anaesthetic will reduce any immediate discomfort from the injection, which generally is quite mild anyway. The steroid will subsequently produce a drastic anti-inflammatory effect and therefore shoulder injections are generally not painful and very well tolerated by patients. Although a very small percentage of people will experience a post-injection flare.
What to do if you suspect you have shoulder bursitis
If you have any questions about injections for a shoulder bursitis, please do not hesitate to contact us by email, firstname.lastname@example.org or by telephone on 0207 482 3875. We are always very happy to answer your questions.
Research Articles of Interest
Chen, M.J., Lew, H.L., Hsu, T.C., Tsai, W.C., Lin, W.C., Tang, S.F., Lee, Y.C., Hsu, R.C. and Chen, C.P., 2006. Ultrasound-guided shoulder injections in the treatment of subacromial bursitis. American journal of physical medicine & rehabilitation, 85(1), pp.31-35.
Hsieh, L.F., Hsu, W.C., Lin, Y.J., Wu, S.H., Chang, K.C. and Chang, H.L., 2013. Is ultrasound-guided injection more effective in chronic subacromial bursitis?. Medicine and science in sports and exercise, 45(12), pp.2205-2213.
Soh, E., Li, W., Ong, K.O., Chen, W. and Bautista, D., 2011. Image-guided versus blind corticosteroid injections in adults with shoulder pain: a systematic review. BMC musculoskeletal disorders, 12(1), p.137.