The Role of Injection Therapies in Treating Shoulder Impingement

Imagine shoulder pain severe enough to prevent you from lifting your arm above your head. The pain bothers you at work. It sometimes prevents you from getting a good night’s sleep. Your first thought might be to visit the doctor, hoping to get a prescription. But what if your doctor suggested injection therapy instead?

Pain medicine doctors, like those at LoneStarPainMedicine.com in Weatherford, TX, have access to several injection therapies that can be utilized as alternative treatments. They are designed to accomplish something different, so it is important for patients and their doctors to talk about each one’s ability to help relieve pain.

The Mechanics of Shoulder Impingement

Shoulder impingement is a syndrome typified by the tendons of the rotator cuff being intermittently compressed during shoulder movements. The compression is a result of the tendon being trapped in the narrow space just underneath the outer tip of the shoulder.

It is normal for the space between the shoulder and rotator cuff to narrow when the arms are lifted. But in a healthy shoulder, there is still plenty of room for the tendons to freely move. Not so for a person with shoulder impingement. Because the tendons cannot glide freely, they make contact with bone or bursa. This causes irritation, inflammation, and pain.

Patients often describe shoulder impingement pain is either sharp and stabbing or an aching discomfort. The pain is usually felt at the front or side of the shoulder and can radiate down the arm. In nearly every case, it is exacerbated when the patient attempts to lift the arm over his head or reach behind.

Injection Therapies and Their Goals

When pain medication is the only solution offered by a doctor, the goal is to simply mask the problem by minimizing the pain experience. Injection therapies are different in nature. They are designed to address the root cause of shoulder impingement.

Here are the three injection therapies pain management doctors normally turn to for treating shoulder impingement:

1. Corticosteroid Injections

Injecting corticosteroids is a strategy designed to reduce inflammation. A doctor will inject a mixture of corticosteroid medication and a local anesthetic directly into the space between the shoulder and the rotator cuff. The anesthetic provides temporary pain relief while the corticosteroid reduces inflammation. Once effectively reduced, there is room enough for the tendons to move without making contact with bone or bursa.

2. Platelet-Rich Plasma (PRP) Therapy

PRP therapy is a form of regenerative medicine. It is used to help the body heal from a musculoskeletal injury or disease. With this procedure, a doctor injects blood (provided by the patient himself) previously spun in a centrifuge to concentrate platelets and growth factors. The injection stimulates the body’s natural healing response to reduce inflammation and heal any damage done to the tendons.

3. Prolotherapy

Prolotherapy actually encourages inflammation as a way to signal to the body that healing repairs are needed. A doctor injects a solution that irritates the tendons and nerves, signaling the body to get to work.

There is yet a fourth injection therapy that doesn’t actually get to the root of the problem. It is designed only to relief pain. It is called a nerve block. Nerve blocks are reserved for severe and chronic shoulder impingement that does not respond to other treatments. In short, it prevents pain signals from ever reaching the brain.

Shoulder impingement can be quite uncomfortable. It can also interfere with daily life. Fortunately, there are treatments that go above and beyond mere pain medication. They are injection treatments typically provided by pain management specialists.