Subacromial Injection

During this procedure, a mixture of anesthesia and anti-inflammatory medication is injected into the space between the acromion and the head of the humerus. This injection can be used to treat a variety of painful conditions, including adhesive capsulitis, rotator cuff tendinosis, and impingement syndrome. The physician may choose an injection site on the front, side, or rear of the shoulder.

Subacromial injection is a procedure used to treat a variety of painful conditions that affect the shoulder. The treatment involves the injection of a mixture of anti-inflammatory medication and anesthesia into the area between the acromion, the area of the scapula that forms the highest point of the shoulder, and the head of the humerus. A subacromial injection may be administered at the front, side or rear of the shoulder. Subacromial injections can be very successful in reducing pain and swelling and restoring a fuller range of motion to the shoulder.

Reasons for Subacromial Injection

Subacromial injections are performed to treat various conditions of the shoulder, which may develop due to overuse of the joint, injury or aging. This method of treatment is primarily recommended for patients who have the following shoulder conditions:

Adhesive capsulitis

Often referred to as frozen shoulder, adhesive capsulitis is a common condition that results in pain and stiffness in the shoulder. Adhesive capsulitis is the result of a tightening or thickening of the capsule of connective tissue that protects the structures of the shoulder. Although the cause of frozen shoulder is unknown, it often occurs after a shoulder injury or shoulder surgery, or as a complication of diabetes.

Shoulder impingement

This condition develops when the front of the shoulder blade rubs against the rotator cuff, causing irritation and pain. Shoulder impingement is one of the most common causes of shoulder pain and occurs more frequently in athletes who lift their arms overhead, such as swimmers, baseball players and tennis players.

Rotator cuff tendinosis

Rotator cuff tendinosis is an inflammation of the tendons attached to a group of muscles in the shoulder. The condition is often caused by activities that require repetitive overhead movements, such as lifting weights or throwing balls, or by traumatic injury such as falling on an outstretched arm. The condition is characterized by shoulder pain and limited range of motion. Rotator cuff tendinosis is the mildest form of rotator cuff injury.

Candidates for Subacromial Injection

Patients are considered good candidates for subacromial injections if they experience lingering painful symptoms in the shoulder despite weeks or months of conservative treatments such as physical therapy, placing ice or cold compresses on the affected shoulder and resting the joint. Older patients who are not considered good candidates for more invasive treatments such as surgery may also benefit from these injections. Additionally, subacromial injections may serve diagnostic purposes, since the injections can help pinpoint the exact source of the patient's pain.

The Subacromial Injection Procedure

Prior to the injection, the patient takes a seated position and the skin on the shoulder is thoroughly cleaned and anesthetized to reduce discomfort. The corticosteroid solution will then be carefully inserted into the shoulder to reach the subacromial space. The anti-inflammatory medication provides pain relief and a reduction in swelling, while the anesthetic in the solution will numb and soothe the joint. Once the needle is removed, a small bandage is placed at the injection site. Ice packs should be applied to the area of the injection immediately following the procedure.

Results of Subacromial Injection

Following a subacromial injection, patients should avoid strenuous activities for a period of several days. While subacromial injections do not provide permanent pain relief, they do offer considerable temporary relief from pain and inflammation. The patient's range of motion generally improves as well. The effects of the injections may last for several months, though repeat injections are eventually necessary to manage painful symptoms. However, subacromial injections should not be administered more than 4 times in a year.

Most patients will experience significant pain relief after a subacromial injection. However, those patients whose severe shoulder pain does not respond to subacromial injections may eventually need to consider undergoing surgery. A common surgical procedure performed to relieve painful shoulder symptoms is known as subacromial decompression. This operation involves the removal of some of the affected tissue and a portion of the bursa, the small sac that has become inflamed. The surgery will usually require 3 to 4 months of recovery.

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  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics