From the FDA Drug Label
For adults, doses up to 10 mg for smaller areas and up to 40 mg for larger areas have usually been sufficient. Single injections into several joints, up to a total of 80 mg, have been given.
The amount of Kenalog (triamcinolone) for a shoulder injection can be up to 40 mg for larger areas. There is no information about Lidocaine amount in the provided drug label. 1
From the Research
For a shoulder injection, a typical combination includes 4-6 mL of 1% lidocaine mixed with 40-80 mg of Kenalog (triamcinolone acetonide), with the most recent study suggesting a dose of 10 mg of lidocaine and 80 mg of triamcinolone acetonide for injection 2. The lidocaine provides immediate pain relief while the Kenalog offers longer-term anti-inflammatory effects.
Key Considerations
- The exact dosage depends on the specific shoulder condition, patient size, and severity of symptoms.
- For smaller joints or less severe inflammation, use the lower end of the dosage range.
- The injection is typically administered into the glenohumeral joint or subacromial space, depending on the pathology.
Administration and Monitoring
- Before injection, aspiration should be attempted to ensure proper needle placement and rule out infection.
- The onset of lidocaine is within minutes, while Kenalog's effects begin within 24-48 hours and may last several weeks to months.
- Patients should be advised to rest the shoulder for 24-48 hours post-injection and monitor for potential side effects such as post-injection flare, skin discoloration, or infection.
Safety Precautions
- Multiple injections should be limited to 3-4 per year in the same joint to minimize steroid-related complications.
- The use of ultrasound guidance can improve the accuracy of the injection and reduce the risk of complications 3.
Evidence Summary
- A study published in 2025 found that triamcinolone/lidocaine ultrasonophoresis demonstrated similar outcomes to injection in reducing pain, improving disability, and enhancing quality of life in patients with acute rotator cuff related shoulder pain 2.
- Another study published in 2017 found that intra-articular corticosteroid injection alone was as effective as capsule-preserved hydrodilatation with corticosteroid in improving pain and function in patients with refractory adhesive capsulitis of the shoulder 4.
- A 2014 study found that the heated lidocaine/tetracaine patch had similar efficacy to subacromial corticosteroid injections for the treatment of pain associated with shoulder impingement syndrome 5.
- A 2002 study found that subacromial injection was a relatively difficult procedure, and a high incidence of injections that missed the subacromial bursa would be a sufficient reason to refrain from repeated usage of corticosteroids 6.
- A 2018 study found that overall pain reduction after ultrasound-guided shoulder injections was favorable in the short term, and there was no specific preinjection point-of-care ultrasound findings associated with clinical pain reduction after injection 3.