What is an intraarticular and subacromial shoulder injection?

An intraarticular injection helps relieve shoulder pain and improves shoulder mobility. Hyaluronans and corticosteroids are the types of substances injected into the shoulder to reduce pain. Naturally, corticosteroids, classified as anti-inflammatories, minimise pain and swelling in the shoulder.

Typically, doctors combine corticosteroids, physiotherapy and rehabilitation to treat several shoulder-related conditions such as AC joint pathology, impingement syndrome and inflammation resulting from arthritides that arise from joint inflammation due to metabolic or infectious reasons.

Hyaluronans also carry numerous benefits, which involve numbing pain receptors and releasing more endogenous synovial fluid to increase lubrication within the joint.

Why do you need an intraarticular/ subacromial shoulder injection?

An intraarticular shoulder injection is a less invasive means of relieving shoulder pain and improving shoulder mobility. Pain relief measures such as corticosteroid/anti-inflammatory injections ensure a better quality of life because, generally, you will notice an improvement in the flexibility and overall movement of the shoulder.

Generally, Dr van Niekerk administers the intraarticular shoulder injection to address shoulder-related conditions such as:

  • Shoulder arthritis
  • Frozen shoulder
  • Injury affecting the rotator cuff
  • Impingement
  • Bursitis
  • Ligament injury

How does Dr van Niekerk administer an intraarticular shoulder injection?

Dr van Niekerk administers these types of injections, depending on the shoulder condition you are suffering from. For example, a glenohumeral joint injection relieves pain from a frozen shoulder and arthritis affecting the movement of the shoulder. Conversely, a subacromial space injection is used to treat pain as a result of impingement, bursitis, impingement affecting the rotator cuff and tendinosis.

Under the guidance of fluoroscopic imaging or ultrasound, Dr van Niekerk can inject the substances into the intraarticular space precisely. He may decide to inject the substance into the glenohumeral joint that can be approached from the back (posterior) or front (anterior) part of the shoulder or the acromioclavicular joint. Dr van Niekerk will ask you to sit or lie down on your back, depending on the cause of the pain and the site he chooses to target. Next, a translucent, watery type of gel is rubbed over the area that will be targeted; this assists with the transfer of sound waves. Next, Dr van Niekerk holds a probe (transducer) over the region. The transducer is responsible for sending sound waves and receiving echoes in return. The sound waves are used to capture images of the area. The images produced on the monitor assist Dr van Niekerk in injecting the medication into the correct space.


What else does Dr van Niekerk use besides an ultrasound to inject the pain relief/anti-inflammatory medication?

He can decide to use live x-ray images or fluoroscopy or only the anatomical bony landmarks.

What does recovery involve?

You will not be able to engage in strenuous physical activity for at least two days after the procedure.

When do I need to return for a follow-up?

At least three to four weeks after the procedure, you should make an appointment with Dr van Niekerk to follow up on your progress.