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Injections
For the Shoulder & Elbow

Injections for Shoulder and Elbow pain is a very common treatment, as well as a useful aid to diagnosis. Steroids have traditionally been used for this and continue to be used. Hyaluronans (HA) are a new alternative to steroids and offer a number of benefits over steroids.

HA naturally occurs in joints. It has a number of functions in the joint of which the main being it action as lubricant and shock absorber. With degenerative diseases, such as arthritis, the natural HA in the joint is reduced (Fig. 1).

Fig. 1: Shrinkage of the cartilage proteoglycans and increased spaces with increasing age.

HA injection works by restoring the normal balance between the breakdown and production of HA in the joint. It also coats the pain receptors and inflammatory cells in the joint. These effects mean that it can decrease pain and stiffness of the joint.

We choose to use a HA called Ostenil (TRB Chemedica), which is licensed for use in the shoulder in the UK. It can be mixed with local anaesthetics and injected safely into the shoulder joint. The HA in Ostenil is very pure and is manufactured using a process called fermentation. It contains no animal proteins, which means it is very unlikely to cause an allergic reaction. Ostenil has been given to thousands of patients and has not been found to cause any serious side effects.

Information following Your Injection:

Injections into soft tissues and joints can be very effective in giving pain relief when the tissues are inflamed. The injection that you have had includes a small amount of Steroid or Ostenil that has an anti-inflammatory action and a local anaesthetic, which numbs the area temporarily.

To gain the most benefit from this injection it is important that you rest the joint from any strenuous activity for 1-week. You will be able to carry out activities of daily living as normal.

The clinician who has given you the injection will have checked your medical history to ensure that you are at minimal risk of any adverse reaction. It is normal to feel some increased discomfort in the area for 48 hours after the injection. However if you notice any of the following symptoms: swelling, redness or warmth around the injection site, or you feel generally unwell, please contact your GP or casualty and tell them about this injection.

It is important that you attend your review appointment so that your clinician can assess the effects of the injection and provide you with additional advice as appropriate.

Additional Information:

- Corticosteroid Injections Review
- Hyaluronan Background
- Hyaluronans in the Shoulder

19/07/2004

Shoulder
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