The first type is cortisone (corticosteroid) shots. They may help treat the inflammation inside the joint. Typically, cortisone is mixed with a numbing agent that provides immediate pain relief. It also helps your doctor know if the injection is in the right place. Once the numbing medicine wears off, the joint may be sore until the cortisone kicks in. It’s important to ice the shoulder for a day or so after the shot.
Cortisone shots don’t damage the shoulder, but most surgeons limit them to no more than a few a year in most arthritis cases. There are cautions with the use of cortisone for those with certain medical conditions. For example, patients who have diabetes may see a rise in blood sugar for some time after a cortisone injection.
The other medicine that can help with shoulder arthritis is synthetically manufactured hyaluronic acid or derivatives similar in structure to the naturally occurring joint fluid, known as viscosupplementation. It should be noted that while this liquid substance has been injected into arthritic knees for many years, it remains an experimental treatment option for shoulders, and most insurance companies do not cover the cost of the procedure.
The shoulder joint contains a small amount of a gel-like substance called synovial fluid. This fluid cushions and lubricates the joint. Synovial fluid has a hyaluronic acid component, which helps to make it viscous, or sticky and thick. If synovial fluid thins out, it becomes less effective as a lubricator.
Your doctors can inject hyaluronic acid, which is typically produced in a laboratory, into the shoulder joint’s synovial fluid to increase the fluid’s viscosity and improve the joint’s gliding motion. This improved joint function may provide pain relief that lasts for weeks or months. Doctors recommend limiting hyaluronic injections to one per year.