A cortisone shot for the shoulder is a common, non-surgical treatment aimed at alleviating severe, localized pain and inflammation. This targeted injection typically consists of a corticosteroid medication combined with a fast-acting local anesthetic. The compound delivers a potent anti-inflammatory agent directly to the source of discomfort within the shoulder joint or surrounding soft tissues. Focusing the medication precisely where it is needed helps manage acute pain and improve joint function. The injection is utilized when conservative treatments like rest, ice, and oral medications have failed to provide adequate relief.
How Cortisone Targets Shoulder Inflammation
The mechanism of a cortisone shot involves introducing a synthetic version of cortisol, a hormone naturally produced by the adrenal glands, into the affected shoulder area. This corticosteroid suppresses the localized immune response that generates inflammation. The medication works at a cellular level to decrease the production of inflammatory chemicals, effectively reducing swelling, redness, and associated pain.
Unlike traditional oral pain relievers, which travel throughout the entire body, the corticosteroid is deposited directly into the site of the inflammation, maximizing its local effect. This targeted suppression helps halt the cycle of inflammation that keeps the shoulder painful and restricted.
Since the corticosteroid takes several days to a week to begin its anti-inflammatory action, the injection mixture also contains a local anesthetic, such as lidocaine. This anesthetic provides immediate, temporary numbing relief that helps confirm the needle’s precise placement and offers comfort until the steroid begins to work.
The long-acting nature of the corticosteroid provides an extended window of pain reduction, often lasting weeks to months. This period of decreased pain facilitates other recovery steps, such as physical therapy, which might otherwise be too painful to perform effectively. By calming the inflamed tissues, the injection allows the patient to regain movement and strengthen the surrounding musculature.
Specific Shoulder Injuries Addressed
Cortisone shots are frequently used to treat conditions where inflammation causes pain and restricted movement. One common target is subacromial bursitis, where the fluid-filled sac (bursa) beneath the acromion bone becomes inflamed and swollen. This swelling reduces the space available for the rotator cuff tendons, leading to impingement and significant pain, particularly when lifting the arm.
The injection is also a standard treatment for various forms of rotator cuff tendonitis, which involves inflammation of the tendons that stabilize the shoulder joint. Swollen tendons rub against surrounding structures during movement, worsening the inflammation and leading to chronic pain. Similarly, inflammation in the joint capsule is the underlying cause of adhesive capsulitis, commonly known as frozen shoulder.
In cases of frozen shoulder, the joint capsule thickens and tightens due to inflammation and scar tissue, severely limiting the shoulder’s range of motion. Injecting the corticosteroid directly into the glenohumeral joint reduces this capsular inflammation, making it possible for patients to begin the strenuous stretching required for rehabilitation. The shot also manages flare-ups of pain associated with glenohumeral osteoarthritis, where inflammation stems from the breakdown of joint cartilage.
Navigating the Injection Process and Recovery Timeline
The process of receiving a cortisone shot is a quick, in-office procedure. Physicians frequently use ultrasound guidance, which involves a real-time imaging device, to visualize the internal structures of the shoulder and confirm accurate needle placement. This precision ensures the maximum therapeutic effect and minimizes the risk of injecting the medication into nearby tendons or blood vessels.
Immediately after the injection, the fast-acting anesthetic provides a period of numbness that typically lasts only a few hours. Once the anesthetic wears off, some patients experience a temporary increase in pain and discomfort, known as a “cortisone flare.” This flare is thought to be an irritation caused by the crystals of the corticosteroid medication and usually subsides within 24 to 48 hours.
The true anti-inflammatory benefits begin to manifest several days after the injection, with patients often reporting significant relief within three to seven days. The duration of relief varies widely, providing pain control for several weeks up to several months. To mitigate the potential for local tissue damage, such as weakening of tendons or cartilage, most medical guidelines restrict the frequency of injections.
Injections into the same joint are typically limited to a maximum of three or four times per year. Other potential, rare side effects include temporary changes in skin color at the injection site or localized fat atrophy, which can create a small dimple in the skin. Patients with diabetes should monitor their blood glucose levels closely following the shot, as the corticosteroid can cause a temporary elevation in blood sugar.