Will A Cortisone Injection Help A Torn Rotator Cuff?
Your rotator cuff comprises four muscles and tendons surrounding the shoulder joint. They provide strength to lift the arm in all directions and provide stability to the shoulder to firmly hold the ball of the shoulder (head of the humerus) in the socket (glenoid).
Management for Rotator Cuff Tears
Tears of the rotator cuff can occur acutely through several mechanisms or can result from gradual changes over time and, in some cases, can cause shoulder pain and reduced function. Good quality research has suggested that physiotherapy and exercise rehab is effective and should be the first-line treatment for many types of rotator cuff injuries. However, in some particularly stubborn cases, other additional options may need to be considered.
A cortisone injection, also known as an HCLA (hydrocortisone + local anaesthetic) injection, is an injection that can help to reduce inflammation and provide pain relief. With the guidance of your physiotherapist and medical team, a cortisone injection may be considered for people with:
- Persistent high pain levels despite medication and relative rest.
- Night pain
- Where pain has restricted the progression of exercise rehab.
Pros and Cons of Injections
A cortisone injection can effectively reduce pain and inflammation in conditions such as bursitis in the right circumstances. However, injections do also have some potential adverse side effects.
Recent studies show that repeat injections or injections involving large tendon tears can weaken the tendon structure and inhibit the cells that help repair damaged tissue. This is why healthcare professionals, such as your physiotherapist, will try to avoid unnecessary steroid injections and persist with rehab for at least 4-6 weeks before considering them.
Rehab Following Injection
Research shows that people experience significantly greater improvements in shoulder pain and function when completing a specific exercise rehab program following a cortisone injection (Holmgren et al., 2012). Following a successful cortisone injection, your physiotherapist can use this reduced pain “window” to allow the more effective exercise of the muscles in the area. Typically, relative rest is recommended for 1-2 weeks following the injection before commencing exercise rehab.
Consulting with one of our PhysioWorks physiotherapists can ensure that your shoulder injury is accurately diagnosed and treated accordingly. Book an appointment, or feel free to call us, and one of our physiotherapists will be happy to help.
More info: Rotator Cuff Syndrome