Steroid injections for Shoulder joint osteoarthritis
Shoulder or “Glenohumeral” joint osteoarthritis is a condition which causes degenerative changes to the joint surfaces called “cartilage” and the subsequent changes to the surfaces and joint fluid cause the shoulder to become painful and inflamed. It is often referred to as “arthritis” of the shoulder. The degenerative changes may be due to normal “wear and tear” of aging, or occupation involving stressful shoulder movements or previous injury or injury to the joint.
As the joint surface degenerates, you may notice a restriction in range of motion and pain with certain activities. Osteophytes (bony spurs) may form which can also create more friction in the joint and potentially irritate the rotator cuff tendons.
Symptoms of shoulder osteoarthritis
- Pain sleeping due to either pressure on that side when lying on the symptomatic side or the arm falling across the body during sleep if you are on the non symptomatic side
- Pain lifting the arm above the shoulder height, out to the side or turning the arm out
- Restricted of shoulder movement and difficulty with daily activities.
Shoulder Joint Anatomy
The Shoulder joint is a ball and socket joint that gets most of its stability from the surrounding muscles and ligaments of the joint capsule.
Shoulder osteoarthritis involves degenerative changes to the cartilage of the joint. The previously smooth joint that would usually allow a large degree of range of motion, begins to stiffen and the rough joint surfaces start to rub on each other irritating the joint.
How to diagnose
A diagnosis for shoulder osteoarthritis is often diagnosed by x-ray. . A diagnostic ultrasound can be performed at Oxford Circus Physiotherapy to assess the joint for swelling, look for osteophytes which are signs of arthritis and help confirm the diagnosis.
Shoulder Joint Osteoarthritis Treatment
The majority of patients with shoulder joint osteoarthritis will manage with over the counter pain relief and a course of physiotherapy. It is important to modify or avoid activities that aggravate your pain and to pace yourself by taking regular breaks.
Physiotherapy aims to improve flexibility and strength of the shoulder joint by prescribing an independent exercise program and providing manual therapy.
Shoulder Joint Osteoarthritis Injection therapy
Injection therapy may be appropriate for you if your symptoms have not improved with physiotherapy and over the counter medication. The injections are performed under ultrasound-guidance to ensure a more accurate and effective treatment, compared to landmark guided injections (Daniels et al, 2018). ElMeligie et al 2022 showed that ultrasound guided steroid injections are an effective treatment option for certain shoulder pain conditions.
Ultrasound-guided corticosteroid injection
A small amount of corticosteroid (an anti-inflammatory medication) is injected into the AC joint under ultrasound guidance. This helps to reduce inflammation and pain within the AC joint.
Ultrasound-guided Hyaluronic acid injection
Hyaluronic acid (HA) is a gel-like substance that is naturally present throughout the human body and provides lubrication to eliminate friction of the joints. Injecting HA into a joint essentially helps lubricate the joint and works as a transport medium for nutrients to assist in healing.
Daniels, E.W., Cole, D., Jacobs, B. and Phillips, S.F., 2018. Existing Evidence on Ultrasound-Guided Injections in Sports Medicine. Los Angeles, CA: SAGE Publications.
ElMeligie, M.M., Allam, N.M., Yehia, R.M. et al. Systematic review and meta-analysis on the effectiveness of ultrasound-guided versus landmark corticosteroid injection in the treatment of shoulder pain: an update. J Ultrasound (2022). https://doi.org/10.1007/s40477-022-00684-1
Oxford Circus Physiotherapy is home to a team of expert Physiotherapists who aim to make people better faster. Based in the heart of London’s West End, offering Diagnostic Ultrasound, Steroid injections, Post Op Rehab and Womens Health Services.
The clinician that assess you is also the clinician who provides the treatment. Our clinicians have Post Graduate Diplomas in MSK Ultrasound and further qualifications in injections including steroids, cortisone, PRP and Hyaluronic acid.
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