Patient information from BMJ

Shoulder injections

Last published:Apr 08, 2020

People usually need a shoulder injection to help with joint problems like arthritis, or to have fluid removed from around the shoulder for testing.

Here, we look at what happens during this short procedure, including whether it will hurt, how it might help, and what the risks are. You can use our information to talk with your doctor about this procedure.

Why might I need a shoulder injection?

Anti-inflammatory injections

Conditions such as osteoarthritis can cause painful inflammation (swelling) and stiffness in joints including the shoulder.

Exercise and anti-inflammatory pills are often enough to control these symptoms. But if you have severe symptoms your doctor might recommend an injection of corticosteroids in your shoulder.

Corticosteroids are powerful anti-inflammatories. This means that they reduce swelling and pain.

You might already have been prescribed corticosteroids as pills. But injecting them directly into where they are needed can sometimes offer better relief for severe symptoms.

Taking fluid for testing

Having fluid taken with a needle is called aspiration. Your doctor might recommend it if you have pain and swelling in your shoulder that could have been caused by:

• an infection in that area, or

• a condition that can cause long-term pain and swelling in the joints.

The fluid can then be tested, which helps your doctor to make an accurate diagnosis and recommend the best treatment for you.

Conditions for which you might need to have fluid taken in this way include:

• septic arthritis

• gout

• osteoarthritis

• ankylosing spondylitis

• rheumatoid arthritis, and

• bursitis. 

What will happen?

Whether you are having an injection of medication or having fluid taken for testing, the procedure will feel the same.

The doctor will gently feel around your shoulder to find the right place for the needle. He or she will then:

• mark with a pen where the needle should go in

• clean the area with an antiseptic wipe

• insert the needle

• either inject the medication you need, or take some fluid into the syringe. This might take a minute or so

• withdraw the needle, and

• apply a small dressing or plaster over the place where the needle went in. 

What are the risks?

Although it’s a short procedure, a shoulder injection can be a bit painful at the time. And corticosteroid injections can cause dull pain for several hours afterwards.

Other possible complications from this procedure include:

• bleeding

• infection

• damage to joints if you have injections frequently, and

• damage to tendons.

These problems are rare, but they do sometimes happen. Your doctor should explain all the possible complications to you before you have the procedure. 

What can I expect afterwards?

If your injection has been to test the fluid in your shoulder, your doctor should arrange a follow-up appointment to discuss the results. The follow-up appointment is also a chance for the doctor to check on any complications that might have been caused by the procedure. If you have had a corticosteroid injection, your doctor should tell you how long the injection will take to work, and how long the painkilling effects should last.

These injections usually take a few days to start working, and the effects last from a few weeks to a few months, depending on the medication used. Your doctor will be able to tell you more.