Shoulder Injection (Subacromial / Glenohumeral / AC Joint)

⚙️What This Procedure Involves

Subacromial injection: the needle is inserted from the lateral or posterior approach into the space between the acromion and the rotator cuff. Glenohumeral injection: the needle enters the shoulder joint, typically from a posterior approach. AC joint injection: a small needle is inserted directly into the acromioclavicular joint from above. The injection may be performed using anatomical landmarks alone or with ultrasound guidance for accuracy. The procedure takes five to ten minutes.

💡Why It May Be Recommended

Subacromial: for rotator cuff tendinopathy, bursitis, and impingement. Glenohumeral: for glenohumeral arthritis, adhesive capsulitis (frozen shoulder), and as a diagnostic tool. AC joint: for AC joint arthritis or osteolysis. Injections serve both diagnostic (confirming the pain source) and therapeutic (anti-inflammatory) purposes.

⚖️Non-Operative Alternatives

Physiotherapy, oral anti-inflammatory medication, activity modification, and topical treatments. These should be combined with injection — not replaced by it.

📋Preparing for Surgery

No fasting. Clinical or ultrasound-guided. Inform clinician about blood thinners and allergies.

✅Expected Benefits

Diagnostic: if the injection relieves pain, it confirms the targeted structure as the source. Therapeutic: pain relief lasting weeks to months. Enables more effective physiotherapy during the pain-free window.

⚠️Common Risks

• Injection site discomfortExpected

  For a few hours to days.

• Steroid flareUncommon

  Temporary pain increase for 24–48 hours.

• Blood sugar riseUncommon

  In diabetic patients. Usually normalises within days.

🔴Less Common but Serious Risks

• InfectionRare

  Very rare with sterile technique.

• Tendon weakeningLong-term

  Repeated subacromial injections may weaken the rotator cuff. Limit to two to three per year.

• Skin depigmentationRare

  Localised skin lightening.

• Facial flushingUncommon

  Systemic steroid effect. Temporary.

💉Anaesthetic Considerations

No anaesthesia needed. The injection contains local anaesthetic.

🏃Recovery and Rehabilitation

Normal activities immediately. Avoid heavy shoulder use for 48 hours. Maximise the pain-free window with structured physiotherapy.

📅Follow-Up

Assess response at two to four weeks. Plan further management based on response.

❓Frequently Asked Questions