From the Guidelines
A steroid injection into the joint can help reduce pain for patients with rotator cuff injuries, as supported by moderate evidence from a 2020 study in The Journal of the American Academy of Orthopaedic Surgeons 1. When considering treatment options for rotator cuff injuries, it's essential to prioritize a comprehensive approach that includes conservative treatments like rest, physical therapy, and oral anti-inflammatories. For patients who haven't found adequate relief from these methods, a steroid injection can be a viable option for short-term improvement in both pain and function. Key points to consider include:
- The use of a single injection of corticosteroid with local anesthetic, as recommended by the 2020 study 1
- The potential for short-term improvement in pain and function, as noted in the same study 1
- The importance of limiting injections to 3-4 per year due to potential side effects, such as tendon weakening
- The need for a comprehensive treatment plan that includes physical therapy to strengthen the rotator cuff muscles and improve shoulder mechanics
- The fact that steroid injections provide temporary relief and do not heal the underlying injury, as emphasized by the need for a multifaceted treatment approach. In terms of specific treatment details, corticosteroids such as methylprednisolone or triamcinolone acetonide, mixed with a local anesthetic like lidocaine, are commonly used, with the injection delivered into the subacromial space rather than directly into the tendon. Pain relief from these injections usually begins within 24-48 hours and may last for several weeks to months, making them a valuable option for patients seeking to manage their rotator cuff injury symptoms effectively.
From the Research
Effectiveness of Steroid Injections for Rotator Cuff Injuries
- Steroid injections into the joint can help with pain for patients with rotator cuff injuries, as shown in a network meta-analysis that compared the effectiveness of different drug injection therapies for rotator cuff injuries 2.
- The study found that corticosteroid injections combined with hyaluronic acid injections can be used for the non-surgical conservative clinical management of rotator cuff injuries 2.
- Another study found that intra-articular injection of corticosteroids after rotator cuff repair does not increase the risk of retears and is an effective and safe treatment method for increasing range of motion and improving clinical scores during the early postoperative period 3.
Comparison with Other Treatments
- A study compared the effects of subacromial injection of steroids or nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rotator cuff syndrome and found that both groups showed improvements in clinical outcomes, with no significant differences in outcomes between the two groups 4.
- Another study found that corticosteroids can relieve pain in rotator cuff tears, and active range of motion is the most important predictor of pain outcomes 5.
- A randomized controlled study found that intraarticular injection of triamcinolone improves pain relief for 3 months in rotator cuff tears, but its action is not prolonged or potentiated by two injections of the drug done at 21-day intervals 6.
Key Findings
- Steroid injections can provide pain relief for patients with rotator cuff injuries 2, 3, 5, 6.
- The effectiveness of steroid injections can be enhanced when combined with other treatments, such as hyaluronic acid injections 2.
- Steroid injections are a safe and effective treatment option for patients with rotator cuff injuries, with no increased risk of retears after rotator cuff repair 3.