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Shoulder Steroid Injection for Frozen Shoulder in London
The cost of a frozen shoulder steroid injection is £270. This includes: Assessment and ultrasound scan, Prescription, injection and follow up report detailing the procedure.
We have 2 procedures available to treat a frozen shoulder. 1) Intra-articular injection of a corticosteroid. 2) Intra-articular injection of a corticosteroid and a hydrodistension which includes stretching of the shoulder joint using saline at the same time as the injection procedure. We can discuss these procedures with you at the time of the appointment and select the best treatment approach for you.
It can start insidiously or after you have had trauma to the shoulder like a fracture or after surgery.
Symptoms of Frozen Shoulder
- A dull or aching pain in your shoulder, which tends to be worse at night or when you move your shoulder joint.
- Stiffness around your shoulder joint that may stop you from moving your shoulder normally. This can make it difficult to do everyday tasks such as driving or dressing yourself.
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The 3 stages of a frozen shoulder
1. Freezing Phase
Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption.
Can last from 2 – 9 months
2. Frozen Phase
Pain starts to subside and progressive loss of shoulder range of movement. Pain only with extremes of movement.
Can last for about 12 months
3. Thawing Phase
Spontaneous, progressive improvement in range of movement.
May last up to 3 years
What causes it?
Onset of this pathology is usually idiopathic (comes on for no particular reason), however there are certain conditions and factors which have been linked to increased occurrence of frozen shoulder.
Such as:
- Female population
- Aged over 40
- Diabetes
- Underactive or overactive thyroid
- Metabolic Syndrome
- Post shoulder surgery or injury
What does a Frozen Shoulder feel like?
Madina’s Journey with a Frozen Shoulder and Steroid Injection Therapy
Madina Shares her Frozen Shoulder journey in this short film. She describes her pain and limitations to movement and how it is affecting her everyday life. We then follow her shoulder steroid injection procedure called a “hydrodistension” and find out how she finds the procedure. If you think you might have a Frozen Shoulder, compare your symptoms with Madina and watch this video to see what the procedure involves.
Anatomy
The shoulder is a ball and socket joint made up of the humerus (upper arm bone) and the scapular (shoulder blade). The socket on the scapula, know as the glenoid fossa, is not very big or deep which then requires additional support to prevent the shoulder becoming unstable. This anatomy however allows for a greater degree of motion that we utilise compared to other joints. To improve joint stability there is a thickening of the capsule that surrounds the joint which encapsulates the joint fluid. These thickenings are the ligaments of the shoulder joint. This is a also a group of 4 muscles that provide stability to keep ball in the socket known as the rotator cuff.
Frozen Shoulder Treatment
Although the majority of the time frozen shoulder will eventually resolve by itself, the current research found that effective treatments which shorten the duration of the symptoms have a significant impact on reducing long term problems.
Frozen shoulder Steroid injections in London
The latest evidence has found that the most effective treatment for frozen shoulder is the combination of physiotherapy and a shoulder steroid injection (cortisone).
A recent systemic review and meta-analysis showed that a steroid injection into the shoulder joint was associated with increased short-term benefits compared with other non-operative treatments and the benefits may last as long as 6 months (Challoumas, et 2020).
The cortisone injection into the shoulder is used to reduce inflammation and pain, which is particularly beneficial in the early stages where pain is a greater issue than stiffness. This can also be performed as a “hydrodistension injection”- where the shoulder joint is also injected with a high volume of saline to stretch the tight joint capsule from the inside and allow movement. Having a course of intense physiotherapy shortly afterwards will then maximise recovery and improve the range of movement of the shoulder. Physiotherapy treatment will involve manual therapy including mobilisation of the joint and an independent exercise program to assist a speedy recovery.
What are the risk factors for developing a frozen shoulder?
- It is more common in the female population
- If you are aged over 40
- If you have type 1 or 2 Diabetes
- If you have an under or overactive thyroid
- If you are recovering from shoulder surgery or had a recent injury to the shoulder
How do I know if I have a frozen shoulder?
- If you have pain around the shoulder that is exacerbated by movement and especially overnight when sleeping
- If you notice your shoulder flexibility is reducing eg you find it difficult to reach behind your lower back or above the head and you are struggling to dress
- If you are not managing with over-the-counter painkillers and the pain is progressively worsening
- If you have tried Physiotherapy or other management and the pain and stiffness is remaining
What other conditions can also mimic a frozen shoulder?
FAQs:
Do I need to have an injection for frozen shoulder?
Will I only need 1 injection?
The majority of patients will only need 1 steroid injection into the shoulder; however the nature of the condition can mean that a second injection may be required. This will depend on your response to the first injection and how much relief of symptoms you get. If you respond positively but it has not given you enough relief, then we may suggest a repeat injection.
Do you use anaesthetic during the injection?
Yes, we do inject local anaesthetic when we do the procedure. This will give you quick relief and make the procedure more tolerable. If you are allergic to local anaesthetic, it is important to discuss this with the treating clinician.
How long will the injection take to work?
References:
Challoumas D, Biddle M, McLean M, Millar NL. Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(12):e2029581. doi:10.1001/jamanetworkopen.2020.29581