Shoulder Pain
Shoulder pain can be an isolated problem in the shoulder or it can be part of a larger pain problem such as rheumatoid arthritis. A combination of history, examination, and laboratory tests are used to diagnose pathology and guide further treatment. Ultrasound is an excellent bedside tool because it can accurately diagnose common shoulder conditions and minimize the need for additional testing. During diagnosis I usually do ultrasound. This reduces the need for additional testing and the need for guided injection to be done simultaneously.
Some of the common reasons for shoulder pain include
- Inflammation, injury or weakening/tear of muscles and tendons around the shoulder joint (rotator cuff)
- Damage to bones, cartilage of shoulder joints as in arthritis of glenohumeral, acromiocalvicular joint
- Bursitis (Bursa allow for smooth sliding of tendons or muscles over the joint or frictional areas)
- Frozen shoulder or Adhesive capsulitis
- Spasm/injury of neck and shoulder muscles
- Referred pain from surrounding areas like neck for example in nerve entrapment or neck joint arthritis
This is a common injection for impingement syndrome, bursitis and/or rotator cuff disorders that have not responded to conservative treatment. We Prefer to do this as a medical procedure under ultrasound guidance. A mixture of local anesthetic and steroid is injected. Ultrasound helps ensure that the medication is delivered to the desired location and reduces the possibility of complications because the needle is always visible.
These injections are used to relieve pain in shoulder arthritis. Glenohumeral joint injection is also performed for cold shoulder. Ultrasound or x-ray guidance helps fine-tune the injection. A mixture of local anesthetic and steroids is injected.
Platelets are one of the blood components. They help in clotting and contain growth factors which promote the healing process. PRP is blood plasma with concentrated platelets. PRP therapy is an attempt to utilise body’s natural ability to heal itself. Growth factors released from the platelets influence and accelerate the repair of tendon or ligaments. It is utilised for tendon or ligament injuries which have not responded to conservative measures such as tennis elbow, golfer’s elbow, plantar fasciitis, achilles tendinosis.
The procedure involves collecting a blood sample from the patient which is then placed in a spinning machine to separate different blood components. The component containing high platelets is separated and then injected at the intended site under ultrasound guidance. Most people require 1 injections at 20-30 days intervals.
