Shoulder pain is one of the most common orthopedic complaints. It can range from mild discomfort — like difficulty brushing your hair — to intense, stabbing pain that wakes you at night.
But what causes shoulder pain? And what’s really going on inside the joint?
Understanding the Shoulder Joint
The shoulder is a complex structure made of bones, tendons, ligaments, and bursae. Its main function is to allow a wide range of movement. So when movement becomes painful, what’s usually to blame?
The answer is often subacromial impingement.
What Is Subacromial Impingement?
Subacromial impingement happens when the rotator cuff tendons rub against the acromion (a bony projection of the scapula). This repeated friction causes inflammation of the tendons (tendinitis) and the nearby bursa (bursitis), resulting in pain, especially when lifting the arm.
Standard Treatment vs. Advanced Options
Traditional treatment includes NSAIDs and physiotherapy. While this helps some patients, others may not improve for weeks or even months.
In our practice, we offer a faster and more precise solution using ultrasound-guided infiltration.
What Is Ultrasound-Guided Infiltration?
Here’s how the procedure works:
- A topical anesthetic is applied to numb the skin.
- Under real-time ultrasound, we insert a needle directly into the inflamed bursa.
- A targeted injection — either corticosteroids or PRP (Platelet-Rich Plasma) — is delivered precisely where it’s needed.
This reduces pain and inflammation almost immediately, allowing faster return to movement and improved outcomes with physical therapy. Many patients feel better within a day.
Why Ultrasound Matters
Unlike blind injections, ultrasound ensures that medication reaches the exact area of inflammation. If you’ve had a cortisone shot that didn’t work, it may not have been placed correctly.
Precision matters. That’s why we use ultrasound for every injection we perform.
When Is Surgery Needed?
In more advanced cases, especially with persistent or recurrent symptoms, we may consider arthroscopic subacromial decompression. This minimally invasive surgery removes bone spurs and reduces pressure on the rotator cuff tendons, allowing proper movement to return.
Final Thoughts
Most cases of shoulder pain can be treated without surgery. The key is early diagnosis, precise imaging, and the right intervention.
Stay tuned for future posts where I’ll cover more causes and treatments for shoulder pain.