Minimally-invasive and invasive treatment options include:
- Intra-articular injections: When oral treatment with anti-inflammatories does not work, patients with a poor response may benefit from intra-articular injections. They contain corticosteroids and can be combined with anesthetic solutions. The injection is directly administered in the affected articulation, and doctors would evaluate if the best application area is the glenohumeral joint, the acromioclavicular joint, or the subacromial space. The only diagnosis in which steroid injections are not recommended is glenohumeral osteoarthritis. In these cases, hyaluronic acid injections are safer and currently endorsed by health authorities. In most cases, intra-articular injections will be administered using a radiographic guide to ensure that the patient receives the drug in the right compartment. Thus, it is often performed by interventional radiologists using fluoroscopy.
- Surgery: In some cases, shoulder pain does not improve despite combining all the therapeutic methods described above. When that happens, surgery is likely required to relieve pain. Surgical referral can also be helpful in shoulder pain with unknown etiology to explore the articulation and adopt corrective measures.
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