Injection of the shoulder

The shoulder consists of a number of sites that are amenable to injection therapy both as a diagnostic procedure and as a form of treatment. These include:

• the glenohumeral joint
• the subacromial bursa and space
• the acromioclavicular joint and,
• a suprascapular nerve block

The choice of injection site and method of approach will vary according to the nature of the symptoms and the precise diagnosis. A good knowledge of the anatomy is required to give these injections accurately. Note that these injections should only be undertaken by clinicians experienced in these procedures.

Repeated injections are to be avoided, as healing of a potential surgical repair may be compromised. (2)

Reference

1. Hopewell S, Keene DJ, Marian IR, et al; Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 x 2 factorial, randomised controlled trial. Lancet. 2021 Jul 31;398(10298):416-428.
2. Puzzitiello RN, Patel BH, Nwachukwu BU, et al. Adverse impact of corticosteroid injection on rotator cuff tendon health and repair: a systematic review. Arthroscopy. 2020 May;36(5):1468-75.