Steroid injection represents a useful tool in the management of chronic shoulder pain. If a doctor deems steroid injections to be of use to the patient, they will typically use a lateral approach to inject the subchromial space, particularly with rotator cuff problems. At different times, the doctor may use an anterior approach or a posterior approach to actually put steroid into the shoulder joint. To conduct these straight injections would be less common though. Ideally, steroids should be thought of as providing temporary relief and when used appropriately, and in conjunction with physical therapy, should serve as a sort of Band-Aid for the shoulder pain. In this way, steroids will give people a temporary period of time in

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which physical therapy can really start working. This is primarily because the steroid is a very effective anti-inflammatory, and for a short period of time will relieve pain enough to conduct therapy.



Steroids have multiple actions. They act as anti-inflammatory, and therefore, frequently will reduce pain in an area with inflammation. Also, and essentially a side effect is that, they will cause destruction of protein. Certainly steroid injections do risk complications, and it is possible to get too many steroid injections into a shoulder. Recently, there has been research to suggest that if someone were to get more than 3 steroid injections into the shoulder, it could make the subsequent rotator cuff repair surgery more difficult.


When it comes to

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making a decision with regards to the use of steroid injections, one should consider that they are a beneficial tool when used appropriately. When used in conjunction with physical therapy, they can be a very effective tool in alleviating shoulder pain. Further, the doctor will perform the steroid injection under sterile conditions as to not introduce germs into the joint space, which further decreases the chance that a problem will arise. This all means that one should not be excessively concerned when a doctor suggests the use of steroid injections, especially when one considers that steroids are actually produced by the body in small amounts.


The steroids injected into the joint are generally safe and do not have systemic side

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affects unlike steroid pills. For those concerned, steroid injections typically will not increase blood sugar levels to a significant degree. Possible side affects/adverse affects of shoulder steroid injection would include an infection, bleeding into the joint if the needle goes through a significant blood vessel, skin can ulcerate if too much steroid is injected closely underneath the skin. Also there can be fat trephine under the skin and essentially leaving a dent in the contour of where the steroid was injected. Additionally, there can be tendon rupture and overall weakening of the structure receiving the steroid.


Michael Carroll, MD is a board certified family physician with a special interest in sports medicine. He is the founding partner of Creekside Clinic,

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LLC, a progressive primary care center in Traverse City, Michigan and a member of both the [http://www.acsm.org/AM/Template.cfm?Section=Home] American College of Sports Medicine, and the American Academy of Family Physicians. He also has an interest in [http://shoulderpainrotator.typepad.com] shoulder pain and [http://shoulderpainrotator.typepad.com] rotator cuff injuries, specifically with regards to cutting edge treatments.