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 What is it? The subacromial space is the area below the hard, bony part on top of the shoulder joint called the acromion and above the rotator cuff tendons that sit on top of the humerus. If the rotator cuff tendon or subacromial bursa in this area becomes inflamed or irritated, sometimes it can be treated with an injection of medication. Specific reasons for an injection include: subacromial bursitis, rotator cuff impingement syndrome, adhesive capsulitis, or rotator cuff tendinopathy. Injections can help reduce pain and inflammation and, in some cases, restore mobility to the shoulder joint. They commonly include an anesthetic, such as lidocaine, and a steroid medication, such as triamcinolone. In other instances, solutions like platelet-rich plasma (PRP) or autologous blood may be injected into the subacromial space to help with healing damaged tissue.
Procedure Details Most of the time a patient will be seated for the injection. A spot on the back or side of the shoulder will be marked and the area cleaned thoroughly. Precautions will be taken to make sure this area is only contacted by sterile material such as the needle. Some providers will use cold spray or an injection of anesthetic medicine to numb the skin before injecting, but this isn’t always necessary. Next, the needle is introduced and guided to the subacromial space. The anesthetic and steroid solution is injected and should flow easily into the subacromial space. There is minimal bleeding in most cases. Some providers will use ultrasound to help guide the injection into the subacromial space for accuracy and to minimize pain.
Post-Procedure Guidance If an anesthetic medication is used in the injection, the shoulder may feel better within minutes after the injection; however, this effect only lasts a few hours. There could be increased pain for the next 24-48 hours, called a steroid flare. This can be treated with ice, nonsteroidal anti-inflammatories (NSAIDS), or acetaminophen. It may take 2-7 days for the steroid medication to provide pain relief. Possible complications from this procedure could include infection, skin discoloration, or tendon injury. For diabetic patients, steroid injections can cause elevated blood sugars for a few days. Complications from subacromial injections are rare and steps are taken to minimize the risk by keeping the area sterile during the procedure and using proper technique.
Return to Play Patients should avoid rigorous activity for 24-48 hours after an injection. Because of potential risk of tendon injury after an injection, sometimes steroid injections are avoided for athletes who are in season for their sport or have upcoming competitions. AMSSM Member Authors References Category: Shoulders, Treatments in Sports Medicine, [Back] |
