Ultrasound Guided Injections
What Is an Ultrasound-Guided Shoulder Injection?
An ultrasound-guided shoulder injection is a procedure used to deliver medication directly into a painful or inflamed area of the shoulder using real-time ultrasound imaging.
Ultrasound allows the provider to clearly see the muscles, tendons, bursae, and joints to improve accuracy and safety.
The injection may contain:
- Corticosteroid (“cortisone”) medication to decrease inflammation
- Local anesthetic to provide temporary pain relief
- Occasionally other medications depending on your condition and treatment plan
Common Indications
Ultrasound-guided shoulder injections may be recommended for:
- Rotator cuff tendinitis or bursitis
- Shoulder impingement syndrome
- Arthritis of the shoulder joint
- Frozen shoulder (adhesive capsulitis)
- Biceps tendon inflammation
- AC joint arthritis
- Shoulder pain related to inflammation or overuse
- Diagnostic evaluation of shoulder pain
Benefits of Ultrasound Guidance
- Improved injection accuracy
- Better visualization of important structures
- Increased comfort during the procedure
- Reduced risk of injury to nearby nerves or blood vessels
- Potential for improved pain relief
How the Procedure Is Performed
- The skin is cleaned using sterile technique.
- Ultrasound gel is applied to the skin.
- The provider uses ultrasound imaging to identify the target area.
- A small needle is guided into the appropriate location.
- Medication is injected.
- A bandage may be applied afterward.
The procedure typically takes 5-10 minutes.
Who will be performing your ultrasound guided injection
One of our Advanced Practice Providers will be performing your injection. They have specific training to use ultrasound while performing injections.
Possible Risks and Side Effects
Most patients tolerate the procedure well. However, possible risks include:
- Temporary soreness at the injection site
- Bleeding or bruising
- Infection
- Allergic reaction to medication
- Temporary increase in pain (“post-injection flare”)
- Skin discoloration or thinning at the injection site
- Elevated blood sugar in diabetic patients
- Facial flushing
- Temporary weakness or numbness
- Incomplete or short-term pain relief
- Rare injury to nearby nerves, tendons, or blood vessels
If you experience fever, significant swelling, drainage, worsening redness, or severe pain after the injection, contact your healthcare provider immediately.
Post-Injection Expectations
After the procedure:
- Mild soreness for 24–48 hours is common.
- Ice may be applied for 15–20 minutes at a time as needed.
- Avoid heavy lifting or strenuous shoulder activity for 24 - 48 hours unless otherwise instructed.
- Avoid heavy lifting or strenuous shoulder activity for 24–48 hours unless otherwise instructed.
- You may continue light daily activities.
- The numbing medication may provide temporary relief for several hours.
- Steroid medication may take 2–7 days to begin working, and occasionally up to 2 weeks for full effect.
Follow-up recommendations will be discussed with you during your visit.
How Many Injections Are Recommended?
The number of injections depends on your diagnosis, response to treatment, and overall medical condition.
General recommendations:
- Most patients should not receive more than 3–4 corticosteroid injections into the same shoulder area within a 12-month period.
- Injections are typically spaced at least 3 months apart when possible.
- Repeated steroid injections may increase the risk of tendon weakening, cartilage damage, or reduced effectiveness over time.
Your provider will discuss the safest and most appropriate treatment plan for your specific condition.
When to Call Your Provider
Contact your healthcare provider if you develop:
- Fever or chills
- Increasing redness or warmth
- Drainage from the injection site
- Severe or worsening pain
- Significant swelling
- New weakness or numbness
Questions?
If you have any questions regarding your procedure or recovery, please contact our office.
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