Pain after shoulder injection

If you have an injection given into the shoulder joint or into the soft tissues around the shoulder then it's normally a painless procedure. Your doctor will carefully direct the injection into either the joint space or into the bursa area - you might find it slightly uncomfortable but it shouldn't be more than that.

Some people however get pain after the shoulder injection. This can either happen within an hour or two or be delayed in it's onset for up to 24 hours. This type of pain is called a "post injection flare."

No one is quite sure what causes the flare response. It may simply relate to the inflamed tissues reacting against the provocation of the needle or the injected substance. Other theories about pain after a shoulder injection is that the trigger is a change in local pH or electrolyte composition due to the effects of the injected drug or drugs (usually it's a combination of a local anesthetic and some locally active steroid agent).

If you are unlucky enough to experience a post injection flare pain after a shoulder injection then try to rest your arm on pillows or cushions, use ice packs and take some pain relief. Anti-inflammatory tablets often help but you should check with your doctor or pharmacist to make certain that these are suitable for you.

Prolonged pain is unusual and may need further investigation.

Pain that gets worse over several days is also rare and can sometimes point to infection as a cause - so again - if this happens to you then you should go see your doctor again for a check over.

Most people who have a shoulder injection get no pain at all - so don't worry too much if it looks like you might need one.

Carpal Tunnel | Pins and Needles | Numb Hand

Carpal tunnel syndrome is caused by pressure on the median nerve as it enters the wrist area.

Nerve pressure anywhere in the body will cause a feeling of numbness, pins and needles - and sometimes pain - in the area of skin that the nerve goes to.

The median nerve goes to the skin of the palm of the hand and supplies the area over the thumb, index and middle fingers.

Carpal tunnel syndrome typically causes pins and needles in the palm of the hand over the thumb and the next two fingers. These pins and needles are sometimes painful but not always. Sometimes the area of skin goes completely numb but again, this is not always the case.

If you think you might have carpal tunnel syndrome then you should consult your doctor for a check up and for further assessment of your symptoms.

Joint Injection Side Effects | Flushing | Sweating

Flushing or sweating is one of the most common side effects after a joint injection.

It seems to be due to the effect of the steroid and can often last for several days. I've had many women (and even some men) complain to me that they thought they were "going through the menopause."

The sweating feelings are short lived and do not indicate any serious underlying problem - simply an unusual effect of the steroid drug as it gets into the body in small amounts after an injection to a joint or to one of the soft tissues of the body.

If the flushing or sweating side effects persist for more than two or three days then you should see your doctor for a check over in case there is some other cause active behind the scenes.

Steroid Injection | Trochanteric Bursitis | Hip Pain Treatment

Trochanteric bursitis is a common cause of pain at the outer side of the hip.

A bursa is a bag of fluid designed to allow muscles to move without friction and the trochanteric bursa sits just beneath the skin over the large prominent hip bone at the top of the hip.

Bursitis is the medical name for inflammation in a bursa.

Trochanteric bursitis causes pain and irritation in the area at the top of the hip on the outer side of the leg. It can arise from no where but often starts after a fall. I've also seen it in people who have been lying too long on hard surfaces or in hard beds - and it can sometimes be found in association with back pain problems.

Steroid injection is a good way to treat trochanteric bursitis . In my experience the success rate is about 70% after only one treatment. The injection is given through the skin straight into the bursa and it's normally a relatively painless procedure.

Hip Injections | Arthritis Pain | Hip Injection Treatment

Hip injections for arthritis are becoming used more often as a method of allowing people to regain some quality of life.

It's not easy to perform an injection into the hip so doctor's often use an x-ray machine to guide the procedure. This is sometimes called "fluoroscopy" and is a good way of making sure that the injection actually goes into the hip joint and not into the tissues round about it.

Hip injections can be done with steroid or with a viscosupplementation product like synvisc or ostenil.

The results are often good in giving pain relief but it can depend on how much wear and tear there is in the joint at the outset.

Carpal Tunnel Injection

Carpal tunnel syndrome is a common problem.

It arises when the median nerve at the wrist is compressed by the bones and soft tissues as it makes its way from the forearm into the hand.

Carpal tunnel syndrome causes pain and pins and needles in the hand.

Various treatment options are available including injection of steroid and local anesthetic. Care needs to be taken during carpal tunnel injection not to inject into the nerve or into a nearby blood vessel. The results of carpal tunnel injection are usually good - with many patients experiencing lasting relief from their symptoms.

Acromioclavicular Joint Pain

The acromioclavicular joint is the joint between the collar bone and the shoulder blade. Often the name of the acromioclavicular joint is shortened simply to the "AC" joint.

In many of us we can see the joint as a prominent bump on top of the front of the shoulder. The AC joint can be injured by direct trauma or by a fall onto an outstretched arm. Sometimes degenerate arthritis can affect it but this too is often the long term end result of an injury.

Acromioclavicular joint pain is nearly always felt in a small area over the joint near to the tip of the shoulder. There is rarely any spread or radiation of the pain and most patients with AC joint pain will point specifically to the area of the joint as the site of their symptoms.

Side effects of joint injections

You'll find more details about joint injection side effects in many of the articles on this site. Use the search function if you need to.

In general terms however, there are several recognized side effects that can go along with a joint injection. These can be divided into "local side effects" (that happen near to the injection site) or "systemic side effects" (that are seen throughout the whole body).

You also need to remember that the vast majority of those who have a joint injection get no side effects at all.

Browse around for more details - or leave a comment about the kind of side effects you've experienced after an injection to a joint.

SI Joint Injections

The SI joint is a short way of describing the sacroiliac joint - the large ear shaped joint between the sacrum bone and the pelvic bones.

Pain from the sacroiliac joint is usually felt in and around the upper buttock area but can spread at times round into the groin or down the leg. Inflammation in the SI joints can arise due to injury, due to problems with the alignment of the joints or as a result of a more widespread inflammation process in the body.

In young men a condition called Ankylosing Spondylitis can be a cause of sacroiliac or SI joint inflammation. This condition is known as sacroileitis.

SI joint injections are technically quite tricky to perform and my own preference is to do them under x-ray guidance .... using an x-ray machine to guide the needle to make sure that the injection is given properly into the joint. The sacroiliac joints lie quite deep inside our body so trying to do a "blind injection" (without x-ray guidance) means that there's quite a high chance of missing the actual joint.

Cortisone Joint Injections

"Do you use cortisone joint injections?" ....

That's a question I'm often asked by patients who consult with me about joint pains. The answer funnily enough is both yes ... and no!

Yes, I use joint injections of anti inflammatory steroid drugs .... but no, I don't use cortisone.

Cortisone was the original drug that was used for injections many years ago. Most doctors now use a modern derivative version - often longer acting than the original cortisone was. Sometimes I might use a drug called hydrocortisone but more often I'm likely to do an injection with Triamcinolone or DepoMedrone. These latter two drugs are both longer acting and more effective than cortisone joint injections used to be.

As in all things, it's important to tailor the treatment to the individual person who needs it, but as rule cortisone itself is now a thing of the past.

AC Joint Injections

The AC joint is the shortened name for the Acromio Clavicular Joint. This is the joint where your collar bone meets the shoulder blade and for most of us it forms a bone bump at the top of our shoulder.

The top part of our shoulder blade is called the acromion and the proper name for the collar bone is the clavicle ... so the joint is called the acromio-clavicular joint.

The AC joint can be injured by a direct blow to the region or by a fall onto the outstretched arm. It is also vulnerable to osteoarthritis changes.

Treatments for AC joint pain include medications, physical therapy and AC Joint Injections. The injection technique is not difficult and the results are usually good.

Shoulder Joint Injection

If you've visited any of my other medical websites, you'll know that shoulder pain treatment is one of my main interest areas. Shoulder joint injection is a useful treatment technique for those suffering from arthritis in the shoulder - and also of course for anyone unlucky enough to struggle with the pain of a frozen shoulder.

Shoulder joint injection is not usually painful if you have it done by an expert. Many doctors, and now too some physical therapists, are skilled in the technique.

My own preference in most patients is to inject the shoulder from the back of the joint - most patients find it more comfortable and the procedure is less intimidating, not least because you don't ever see the needle approach your skin !

Check out these pages for more information about how a shoulder joint injection technique can help you find pain relief.

Hip Injection

Hip Injection for arthritis or for hip joint pain

Injecting into the hip is becoming increasingly common as a treatment for arthritis or hip pain. The hip is a deep seated joint in the body and it's one of the injection techniques that really does require an x-ray machine to guide the needle.

This x-ray guide technique is called "fluoroscopy" and allows the doctor to make sure that the needle is properly placed in the joint before giving the hip injection.

Hip injections are an effective treatment for osteoarthritis or inflammatory arthritis in the hip joint.

Sometimes the injection consists of an anti inflammation drug such as a steroid. Sometimes the doctor will choose to use a viscosupplementation hip injection with Synvisc or Ostenil.

Occasionally only local anaesthetic will be injected - this latter approach can help your specialist to decide if the pain you are having really is coming from the hip or not. This is often called the "walking test" or "walk test."  A physical therapist will watch you walk and measure pain before the procedure. The hip joint injection is then done using x-ray guidance and only local anesthetic is injected. Thirty minutes or so later the physical therapist will assess you again to see if pain and mobility have improved ... if they have then it's certain your pain lies in the hip.

Joint Aspiration

Joint Aspiration Treatment for Joint Pain and Effusion

Joint aspiration refers to the process of removing fluid from a joint. It is usually performed before a joint injection is done but can sometimes be a stand alone technique for the relief of joint pains.

Fluid called synovial fluid builds up when a joint is inflamed. This is called a joint effusion and the pressure that is generated can make the joint more painful and stiff.

Removing this build up of joint effusion fluid is called joint aspiration. It needs to be done under sterile conditions. The amount of fluid removed will vary depending on which joint is involved and on how big an effusion is present. I've often removed well over 100ml of fluid from an inflamed knee but an elbow joint effusion might hold only 10 or 20 milliliters.

Wrist Joint Injections

Wrist injections are helpful for conditions such as wrist osteoarthritis or rheumatoid arthritis.

Injections around the wrist can also be given for tendon problems or for conditions such as carpal tunnel syndrome.

The technique for a wrist injection partly depends on the cause of the problem. In rheumatoid arthritis at the wrist the injection technique is made easier by the amount of boggy swelling around the joint.

If the problem in the joint is one of osteoarthritis then it can be more difficult to place the needle into the joint. Osteoarthritis (or OA) often leads to a narrowing of the space in the joint and the injection can be more tricky for this reason. In some cases of osteoarthritis the wrist injection needs to be given using an x-ray machine to guide the process.

In general the results from an injection into the wrist are good - but the benefits are not always long lasting.

Some doctors are experimenting with using viscosupplementation injections for wrist problems - injecting synvisc, supartz, ostenil or durolane into the wrist joint.