Chronic shoulder pain can be debilitating. Normal daily activities such as lifting laundry from the washing machine, carrying groceries from the car into the house, or reaching for an item on a tall shelf can become difficult to perform and cause major discomfort. When pain continues to worsen or fails to respond to other forms of treatment, minimally invasive epidural steroid injections (ESI) may provide some patients the pain relief they need to be able to comfortably perform a wide range of tasks.
The board-certified physician and pain specialist work closely with patients to determine how to best alleviate their shoulder pain and its accompanying symptoms. Whether used on their own, with other medications, or as part of a rehabilitation program, ESIs can be an effective tool for helping patients feel better and function normally again.
What Causes Shoulder Pain?
A complex and flexible joint, the shoulder is comprised of ligaments, tendons, and muscles. It also features a trio of bones. The humerus is located in the upper arm, the scapula is the shoulder blade, and the clavicle is also known as the collarbone. The top of the upper arm fits into a round socket, called the glenoid, which is in the shoulder blade. Meanwhile, the rotator cuff, which is a set of tendons and muscles, provides stability and mobility and keeps the shoulder joint in its proper place.
The list of conditions that result in chronic shoulder pain is lengthy. Some of the most common causes include bursitis, osteoarthritis, sprains, tendonitis, adhesive capsulitis (also known as “frozen shoulder”), and impingement syndrome, which is sometimes referred to as swimmer’s shoulder and is due to inflammation that results following repetitive activities.
Most frequently, shoulder pain is caused by rotator cuff injuries. As part of the natural aging process, the rotator cuff can become more prone to experiencing injuries. As a result, men and women may employ other muscles to reach for and pick up items. This action can cause pain that is experienced in the shoulder. It is possible that your rotator cuff has been injured if you feel dull, aching pain that develops in the shoulder or on the outside area of your upper arm. This discomfort usually is most noticeable when you lift items, reach behind your back, or above your head. It typically persists even at night and may disrupt sleep, although it is often improved when the arm is rested.
What Are Epidural Steroid Injections?
When physical therapy, refraining from activities that aggravate pain, anti-inflammatory medications, and icing the area fail to alleviate shoulder discomfort, the pain management physician may recommend epidural steroid injections. These can play an important role when it comes to treating shoulder injuries and pain. When paired with physical therapy or other rehabilitative efforts, in some patients, ESIs may even reduce the need for surgery.
Cortisone is a medication that has been used for decades to treat inflammation and reduce swelling associated with numerous musculoskeletal conditions. Steroid injections feature a combination of a corticosteroid as well as a numbing agent such as lidocaine. The skin is numbed with local anesthesia before the cortisone is injected to relieve pain. The pain-relieving results of ESIs can be long-lasting. During this time, the condition that caused the shoulder pain initially can be addressed with physical therapy or other beneficial exercises.
Who Is a Candidate for an Epidural Steroid Injection?
For men and women whose chronic shoulder pain is the result of injury or inflammation and has not responded well to the effects of anti-inflammatory medications, physical therapy, or other efforts, an ESI may be recommended. However, patients who are pregnant, battling infections, or who have experienced bleeding issues may not be suited for the treatment. Also, in some cases, ESIs can cause blood sugar levels to become slightly elevated among patients with diabetes. They also may temporarily elevate blood pressure or eye pressure among those with glaucoma. A board-certified physician can expertly determine whether a patient is a good candidate for an ESI.
What Happens During Treatment?
Before receiving your ESI, the pain management physician will examine your shoulder and inquire about your symptoms, as well as about your general health and about any medications that you take. Every effort is taken to make patients feel relaxed and comfortable during their appointment, which usually lasts less than an hour. The skin is numbed with local anesthesia, the cortisone is injected, and the needle is removed. Once delivered, the corticosteroid and numbing agent work to reduce the pain and swelling in the shoulder. Nearby nerves are also numbed, effectively blocking pain signals to the brain, which should result in the relief that patients seek.
Recovery & Results
Most patients experience some pain relief soon after their ESI procedure and are able to resume their regular activities the following day. As numbness from the procedure wears off, some soreness may be experienced at the injection site. This usually can be improved by icing the area or by taking a pain reliever such as Tylenol. The relief of shoulder pain that may be experienced following an ESI can last for many months.
Pain Relief Can Be Yours
Chronic shoulder pain can prevent patients from performing even the simplest of tasks and impacts their daily activities. When inflammation is the cause of this discomfort, and symptoms have not responded well to other forms of treatment, minimally invasive epidural steroid injections may be used to provide long-lasting relief and allow the shoulder to heal.
Precision Pain Care and Rehabilitation has four convenient locations in Richmond Hill – Queens and New Hyde Park, Lindenhurst, and Valley Stream – Long Island. Call the Queens office at (718) 215-1888, or (516) 419-4480 for the Long Island offices, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.
