Shoulder steroid (cortisone) injection London

Frozen shoulder is a common condition affecting patients usually between the age of 40-60, with women affected more frequently than men. The diagnosis is made based on history and examination findings with pain and restriction of movement that develops over weeks to months.

Once a diagnosis of frozen shoulder has been established, often there will be a discussion around the available injection options.

The two main options include a standard low-volume injection of steroid and local anaesthetic to the ball and socket joint OR a hydrodilatation (high volume) injection which involves the use of steroid, local anaesthetic and water for injection. This type of injection looks to mechanically stretch a tight capsule.

Your doctor will explain the rationale for the particular type of shoulder injection. After this the doctor will discuss the risks and benefits of the injection, using a written consent form.

For the Hydrodilatation procedure the patient will tend to be positioned lying on their side. The doctor will identify the back of the ball and socket joint with ultrasound and mark the site of the injection. This is then followed by cleaning of the injection site using a sterile technique to reduce the risk of infection.

A small volume of local anaesthetic is then injected from the skin down to the ball and socket joint. This is used to numb the area and reduce pain associated with the injection.

After several minutes a further needle is placed into the back of the ball and socket joint and the doctor will inject 1-2mls of steroid combined with 10mls local anaesthetic under ultrasound guidance to ensure that the injection is placed in the correct location. This is then followed by 20-30mls of water to expand the tight capsule. This part of the procedure can result in a pressure build up and patients often feel numbness or ‘deadness’ into the arm.

The needle is then removed and a plaster is placed on the site of the injection. If the patient is feeling well they are asked to sit up and are given post procedure advice.

In general the local anaesthetic will reduce pain for the next 4-5 hours however a flare in the original pain may be expected for one to 2 days after the procedure. Basic painkillers such as ibuprofen and paracetamol can be taken (if tolerated) during this period and frequent icing of the area can be beneficial, i.e. for 10 to 15 minutes on, then one hour off, ensuring that a cloth is placed between ice and the skin to avoid burns.

The patient is asked to look out for any signs of infection and are advised to seek advice if the area becomes hot, tender, swollen or red, or if they develop systemic symptoms such as a temperature.

The patient is usually then reviewed four weeks after the injection to check on progress.

If you would like to book a rapid-access appointment at either our Golders Green or Chelsea clinic locations then please call 0208 0046659, visit www.thejointinjectionclinic.com or email [email protected] for further information.