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February 2020

Should I get a cortisone injection?

By | Pain Relief | No Comments

Has your doctor recommended a cortisone injection to help relieve your shoulder pain?

Are you wondering why you would get a cortisone injection and what they do?

Then let’s start there! Your doctor may recommend that you have a cortisone injection if you have a painful muscle or joint that is inflamed. The cortisone is injected directly into the muscle or joint and decreases the inflammation. You see, cortisone is a powerful anti-inflammatory. By decreasing the inflammation, the pressure in the muscle or joint will also be decreased. Once the pressure is decreased you will feel a decrease in the pain.

Decreased inflammation = decreased pressure + time = decreased pain

Do cortisone injections really work?
While the theory for cortisone injections is sound the research tells another story. A recent study concluded that “corticosteroid injections provide – at best – minimal transient pain relief in a small number of patients with rotator cuff tendinosis and cannot modify the natural course of the disease”. Which means that the cortisone injection may help decrease pain in the short term but will not provide the long term benefits needed to heal a rotator cuff issue.

A different study from the Annals of Internal Medicine compared 3 steroid injections with Physical Therapy treatment. This study found that both groups reported a 50% improvement in pain and disability after one year. However, the steroid injection group had more return visits to their primary care doctor and a higher request for additional steroid injections. Basically, Physical Therapy was able to provide the same benefits while decreasing the number of doctor visits after treatment and decreasing the need for drugs.

Are there any side effects from a cortisone injection?

YES! It has long been known that steroid injections lead to degeneration of the soft tissues of the area it is injected into, potentially leading to tendon tears in the future. That cortisone injection you get today to deal with a rotator cuff tear leads to a weakening of the rotator cuff muscles which increases the risk of further tears in the future.

AND, the medical community is starting to question if cortisone injections into joints actually leads to an increased risk of arthritis. A recent report in Radiology observed patients who had previously received steroid injections and found that some of the patients exhibited further joint damage on medical imaging tests. This study is concerning to those who have been told they need to have an injection to decrease pain from arthritis.

PLUS, there are other potential side effects from a cortisone injection including muscle weakness, slow wound healing, and high blood pressure. Just to name a few! The cortisone is injected locally but travels throughout your body and can cause problems to other systems.

Would you prefer a completely natural way to treat your shoulder pain?

Physical therapy offers a more holistic approach to treating your shoulder pain. It is true that there isn’t a one-size-fits-all solution. Our treatment model is entirely based around addressing the root cause of your pain instead of just providing temporary relief. This allows us to be non-invasive, movement-based, and entirely customized to YOU.

If you have been told that you need a cortisone injection to deal with your shoulder pain we would like you to get informed about other options. We offer a completely natural route to get your shoulder moving again. Want to find out how? Then schedule a FREE 20 minute Discovery Visit to talk with one of our specialists now.

Do you have Shoulder Pain?

By | Uncategorized | No Comments

Do you have pain when you reach into the cabinet for your favorite coffee cup?

Do you struggle to lift your arm to put on deodorant or wash your hair?

Are you limited with your arm motions due to pain?

You may be struggling with “shoulder impingement”.  What does that mean?

Well, the shoulder is a complex structure made up of bones, muscle, tendons, and ligaments.

The bones involved are the humerus (even though shoulder impingement isn’t funny!), the collar bone (AKA – clavicle), and the shoulder blade.  Yes, the shoulder blade (or scapula) must be included when you are discussing the bones of the shoulder.  See, the shoulder blade has to move or else the rest of the bones and muscles can’t move correctly.

Also, there is a bony part of the shoulder blade called the acromion.  This part of the shoulder blade makes up the top part of your shoulder.

Put you hand right on the top of your shoulder. Do you feel that bony part right at the edge of your shoulder?  Just before your hand falls of the shoulder.  That is called the “acromion process”.

The acromion process is super important because it creates the “top” of the shoulder.  The humerus makes up the “bottom” of the shoulder.

In between the acromion process and the humerus is an open space.  What is in this space?  Several things!

  1. Tendons – these attach muscle to bone. The muscles are on the shoulder blade and attach into the humerus.
  2. Ligaments – these attach bones to each other. There are tons of ligaments in this area attaching all those bones together.  They can get tight and hold the bones too close together.
  3. Bursa – these are sacks filled with fluid. They are found in between muscles and bones.  Bursa help keep the muscles from scraping on the bone.  But, when they get inflamed they can get too big.  This is called bursitis.

The tendons, ligaments, and bursa are all together in the very small space between the shoulder blade and the humerus.  Normally, this is fine and we can do everything we want.  However, when one of them starts misbehaving or gets swollen, trouble ensues.

You start to have pain when you are trying to lift your arm up.  Initially it may just be a little bit of pain and you can move through it.  Over time the pain increases as you try to continue reaching for your coffee cup, put on deodorant, wash your hair, or grab the cookie jar you put up high to keep the kids out of it.

Then you have a full blown shoulder impingment.  It gets to the point that any time you reach your arm up it becomes painful.  This is very limiting to all of your activities and frustrating to many people.

The great news is that there is an easy solution that doesn’t involve pain killers, expensive procedures, or even surgery.  It’s called Physical Therapy.

We look at your shoulder and figure out what started the problem in the first place.  We then develop a plan to eliminate the shoulder pain and restore normal motion in your shoulder.  The final step is giving you some exercises that you can do to help your shoulder move better.

Don’t worry, the exercises are never painful and we make sure you can do them at home!  Unless you don’t want to.  If you want to come into our clinic and do your exercises then we can do that too!

If you are suffering from shoulder impingement please know that there is help.  You can access Physical Therapy without having to see a doctor.  We can tell you if what you have is shoulder impingement and develop a plan to get you back to a pain-free life.

What’s the first step?  Simply click here and fill out a short contact form.  We will be in touch to get you on your way back to your favorite coffee cup in no time.