How can infiltrations help me to relieve shoulder pain?
GENERAL INFORMATION
Shoulder pain is due to different pathologies and has many possible causes. It usually starts with conservative management consisting of oral pharmacological treatment (anti-inflammatory drugs, muscle relaxants) and rehabilitative management (manual therapy, ultrasound, shock waves, magnetotherapy…).
When the first step is not enough and we exhaust this more conservative option, we consider the option of performing different types of infiltrations in the shoulder joint or adjacent musculature, to improve pain and achieve normal mobility.
how infiltrations help us
Reduction of inflammation
Corticosteroids are anti-inflammatory medications that can reduce inflammation in the shoulder joint. This is especially beneficial when the cause of the pain is related to inflammatory processes, such as bursitis or tendonitis.
Pain relief
The local anesthetic, which is often administered along with the corticosteroid, provides temporary pain relief by blocking nerve signals in the treated area.
Improved mobility
By reducing inflammation and pain, infiltrations can allow for improved mobility of the shoulder. This can facilitate participation in rehabilitation therapies and exercises to strengthen the affected area. Thus avoiding stiffness, limitation of movement and pain.
Diagnostic facilitation
In some cases, infiltrations may also have a diagnostic component. If pain relief is significant after infiltration, this can help health care professionals identify the source of the pain and guide future treatment.
The beneficial effect of the infiltration does not become palpable until at least 48 hours after the infiltration. If the response is favorable, other infiltrations can be performed to eradicate the totality of symptoms, in which case they should be spaced apart for a prudent period of time.
A few hours of rest and the application of local cold and an oral analgesic (if necessary) are always recommended after the infiltration. Overloading of the infiltrated area should be avoided and the evolution of the infiltration should be checked after 7-10 days.
More than one infiltration may be necessary to completely eradicate symptoms.
WHICH DRUGS ARE ADMINISTERED
- Corticosteroids: Powerful anti-inflammatory drugs of first choice in local treatment.
- Local anesthetic: They are used in combination with corticosteroids to relieve the painful sensation temporarily.
- Hyaluronic Acid: A substance that is found naturally in the human body and has several important functions, being key in the cushioning and lubrication of the joints. In cases of shoulder osteoarthritis it will be useful to recover or improve the mobility of the joint.
- PRP (Platelet Rich Plasma): Product that we obtain after centrifuging the patient’s own blood, the part rich in platelets is used, infiltrating this same inside the joint, with the objective of regenerating the affected or injured tissues and joints.
WHERE THESE INFILTRATIONS CAN BE ADMINISTERED
- Joint (glenohumeral, acromioclavicular): Infiltrate corticosteroids with local anesthetic, hyaluronic acid or PRP. It is also possible to perform hydrodissection of the joint in frozen shoulders/adhesive capsulitis with a combination of corticosteroids, local anesthetic and saline.
- Tendons/muscles: Infiltrate corticosteroids with local anesthetic or PRP in the rotator cuff structures when affected.
- Nerves: We can infiltrate the nerves that give sensitivity to the shoulder joint and reduce its pain. If this technique is effective, a radiofrequency of this same nerve can be considered in the future.
BENEFITS OF INFILTRATIONS IN PAIN TREATMENT
The purpose of infiltrations is to reduce and/or eliminate pain and the rapid recovery of mobility and functionality through the inoculation of a drug.
It is indicated in those diseases that are rebellious to pharmacological treatment and before resorting to other more aggressive therapeutic options such as surgery.
Athletes are a group in which infiltrations are performed in different types of injuries: knee tendinitis, plantar fasciitis, tennis elbow, among others.
Patients of all ages can benefit from infiltrations.
It is important to remember that most of these treatments will have a limited duration in time and have to be performed within a multidisciplinary treatment that includes a good rehabilitation.