Can cortisone injections help with shoulder pain?

If you suffer from shoulder pain associated with common shoulder ailments, you may have considered injections as part of your treatment plan. Doctors usually advise conservative approaches such as physical therapy or injections before recommending surgery to their patients.

The most common type of shoulder injection therapy involves the use of corticosteroids, also known as steroids. Steroids are synthetic drugs that closely resemble cortisol, a hormone that our adrenal glands produce naturally.

Dr. Benjamin Dubois, an orthopedic surgeon affiliated with Sharp Grossmont Hospital, answers some common questions about steroid injections for chronic pain.

What are cortisone injections and how are they used to treat shoulder conditions?
Cortisone is a powerful anti-inflammatory that can be injected into the shoulder area to help treat a variety of shoulder conditions, including tendinitis, bursitis, rotator cuff impingement or tear, frozen shoulder, and degenerative or inflammatory arthritis. Steroid injections are readily available and can be administered in your doctor's office.

How are they given?
We inject the cortisone under sterile conditions after applying a numbing spray to the site. No anesthesia is required. There may be slight burning or pressure. We give the injection with the use of ultrasound imaging, which allows us to visualize the tissue on a monitor in order to allow for a more precise injection procedure. Most patients are pleasantly surprised that it is not a painful procedure.

What are the benefits?
Cortisone injections offer quick, easy and safe relief for inflammation. It should be noted that the shots themselves are not pain relievers. The cortisone lowers inflammation, which is something that can alleviate pain. Some are considered temporary solutions, although some cortisone shots successfully treat shoulder pain permanently.

What are the disadvantages or possible side effects?
As with any medication, there are possible side effects or risks involved. Common risks include pain at the injection site, bruising, skin discoloration, and aggravation of inflammation. Cortisone can weaken tendons and diminish healing rates for subsequent surgeries. Also, there is a possible increased infection rate if the same joint undergoes a replacement within three months.

In your practice, when do you recommend this type of treatment for your patients?
A variety of patients and shoulder conditions are candidates for cortisone shots. I have a discussion with my patients regarding the pros and cons of cortisone. I take it on a case-by-case basis in terms of who is a good candidate for this treatment option.