Glucocorticoid injections under the acromion | Physiotherapy for shoulder arthrosis (omarthrosis)

Glucocorticoid injections under the acromion

In the case of severe therapy-resistant pain, cortisone injections into the shoulder joint may be considered. The medication is injected directly under the acromion. Cortisone is a glucocorticoid, similar to a hormone naturally produced in the human body, cortisol.

Like cortisol, cortisone has an anti-inflammatory and pain-relieving effect. The effect can be targeted by local injection. The effect of these injections is usually short-term but effective.

Some patients can also benefit from the injections in the long term. A critically regarded side effect of cortisone is a cartilage-damaging effect. Although it relieves the inflammation and pain, it can further worsen the condition of the joint. Here too, consultation with the doctor treating the patient is necessary.

Surgery for shoulder arthrosis

If all possibilities of conservative therapy have been exhausted and/or the shoulder arthrosis is already very advanced, surgery may be considered. There are various options for surgical intervention.

  • Firstly, shoulder arthroscopy is possible, in which the shoulder joint is cleaned with the help of a small procedure, the cartilage can be smoothened somewhat and any unevenness can be removed.

    In addition, a bursa can be removed to create more space for shoulder movement.

  • Another possibility is cartilage transplantation, but this method is controversial in the shoulder joint and a successful treatment cannot be guaranteed.
  • As a last resort, a shoulder joint prosthesis can be inserted.

Pro: Shoulder arthrosis is a progressive disease and cannot be cured, so in severe cases surgery can treat the cause of the symptoms. However, the outcome of an operation depends to a large extent on the patient’s cooperation and motivation in the follow-up treatment. The mobility, coordination and strength of the operated shoulder are practiced.

In most cases, injuries such as torn tendons should be treated surgically. However, you should clarify this personally with your doctor.Contra: Good results can be achieved with conservative measures in cases of incipient shoulder joint arthrosis. Ultimately, any intervention in the joint can be a new cause of further wear and tear, so surgery is only useful if all conservative measures have been exhausted and no further improvement in symptoms is achieved.

More information on shoulder prosthesis surgery is available in the article Physiotherapy after a shoulder prosthesis surgery. If both shoulder arthroscopy and shoulder endoprosthesis surgery are performed under general anesthesia, hospitalization is expected to last from a few days to 1-2 weeks, depending on the therapy used. After that, a splint (Gilchrist dressing) is usually worn for up to 4 weeks, but may be removed for the exercises. Depending on which surgical procedure was performed, the arm can be used in everyday life again after 3-12 weeks. These times are very individual and should be discussed with the treating physician.