Corticosteroid Injections and the Shoulder: Shoulder pain is a common complaint that can significantly impact your daily life, limiting your range of motion and reducing your ability to perform even the simplest tasks. One of the most effective treatments for chronic painful shoulder conditions is the corticosteroid injection. This minimally invasive procedure can offer relief from inflammation, reduce pain, and help restore normal shoulder function.
For individuals suffering from conditions like frozen shoulder, bursitis, rotator cuff tendinopathy, or shoulder osteoarthritis, corticosteroid injections can be a game-changer, offering relief when other treatments haven’t worked. But what exactly is a corticosteroid injection, and how can physiotherapy play a role in your recovery?
What is a Corticosteroid Injection?
A corticosteroid injection is a medical procedure where a combination of anaesthetic (to reduce pain) and cortisone (a powerful anti-inflammatory drug) is injected directly into the shoulder. This mix helps to reduce inflammation and offers immediate pain relief, allowing patients to regain movement and strength in their arm.
Corticosteroid injections are particularly useful for treating chronic shoulder pain caused by inflammation, which often leads to a drastic reduction in shoulder mobility and function. By addressing the inflammation directly, this treatment enables the patient to return to a more functional state.
Where Can Corticosteroid Injections Be Administered?
Corticosteroid injections can be administered to three primary areas of the shoulder depending on the specific condition being treated:
- The Shoulder Joint: Injections are used to treat conditions such as frozen shoulder (adhesive capsulitis), osteoarthritis, rheumatoid arthritis, and bicipital tendonitis. These conditions are often characterized by joint stiffness, inflammation, and pain, which can severely limit shoulder movement.
- The Sub-Acromial Space: This is the space between the top of the shoulder blade (acromion) and the rotator cuff tendons. Conditions like impingement syndrome, bursitis, and rotator cuff tendinopathy can cause pain and inflammation in this area. Corticosteroid injections can reduce inflammation and create more space, alleviating pain and improving range of motion.
- The Acromio-Clavicular (AC) Joint: Located at the top of the shoulder, this joint connects the acromion (part of the shoulder blade) to the clavicle (collarbone). Conditions such as osteoarthritis and rheumatoid arthritis of the AC joint can cause pain and stiffness. Corticosteroid injections help reduce inflammation, providing relief from these symptoms.
How Does a Corticosteroid Injection Work?
When injected into the affected area, the anaesthetic component of the injection provides immediate pain relief, which can last for several hours. This is particularly helpful for patients who have been living with chronic pain.
The cortisone part of the injection, which is a potent anti-inflammatory, works over a longer period to reduce inflammation in the shoulder joint or surrounding tissues. This reduction in inflammation helps decrease pain, improve shoulder function, and facilitate better movement.
Physiotherapy After a Corticosteroid Injection: Essential for Long-Term Recovery
While corticosteroid injections are highly effective at reducing pain and inflammation, it’s important to note that they do not address the underlying causes of the shoulder pain or dysfunction. This is where physiotherapy becomes an essential component of treatment. Without rehabilitation, patients may experience a recurrence of symptoms, as the injection alone does not correct any biomechanical or postural issues contributing to the condition.
Physiotherapy plays a key role in:
- Rehabilitation and Strengthening: Once the pain has been reduced through the injection, physiotherapy helps to restore normal movement and strength to the shoulder. Targeted exercises work on strengthening the rotator cuff muscles, improving posture, and stabilizing the shoulder joint to prevent future injuries.
- Addressing the Root Cause: While the injection treats the immediate symptoms, physiotherapy focuses on correcting the underlying cause of the pain, such as poor shoulder mechanics, muscle imbalances, or improper posture. This reduces the risk of re-injury or recurrence.
- Restoring Range of Motion: Chronic shoulder conditions often result in a limited range of motion. Through manual therapy, stretching, and mobility exercises, physiotherapy helps to restore full shoulder movement, enabling patients to perform daily activities without discomfort.
- Pain Management: Post-injection, physiotherapists can guide patients through a personalized program that includes soft tissue massage, joint mobilization, and postural exercises to maintain pain relief and prevent stiffness.
- Monitoring Progress: It is important for patients to return for a physiotherapy session within a week after their injection. Physiotherapists work closely with shoulder specialists and consultants to monitor the patient’s progress and provide feedback throughout the rehabilitation process.
Are Multiple Injections Necessary?
In some cases, one corticosteroid injection may not be sufficient to completely resolve the pain and stiffness. Occasionally, patients may require a second injection to fully eliminate their symptoms, especially in cases of severe or long-standing inflammation. It’s essential to follow up with both your physiotherapist and doctor to ensure the treatment is effective and to make any necessary adjustments to the rehabilitation plan.
Combining Corticosteroid Injections with Physiotherapy for Best Results
For optimal results, it is recommended that corticosteroid injections be used in conjunction with ongoing physiotherapy. While the injection helps reduce inflammation and pain in the short term, physiotherapy addresses the long-term recovery process, ensuring that the shoulder remains strong, mobile, and functional.
If you are experiencing chronic shoulder pain or have been recommended a corticosteroid injection, I can provide you with the necessary physiotherapy support to ensure a successful and lasting recovery. By working together with shoulder specialists, I offer a comprehensive rehabilitation program tailored to your needs, helping you get back to your normal routine as quickly and safely as possible.
To learn more about how physiotherapy can support your recovery after a corticosteroid injection, or to book an appointment, please contact me at 07813 912 313 or email tors@stoneystrettonphysiotherapy.co.uk.