Advanced Injection Therapies

Injection therapies can be useful tools for managing shoulder pain, reducing inflammation, improving function, and helping selected patients delay or avoid surgery.

Dr. Streit offers evidence-informed treatment options for shoulder pain, including corticosteroid injections, platelet-rich plasma, and selected biologic injection therapies when appropriate.

Corticosteroid injections

Corticosteroid injections are commonly used to reduce inflammation and pain in the shoulder. They may be helpful for conditions such as bursitis, rotator cuff inflammation, adhesive capsulitis, and shoulder arthritis.

The primary benefit of corticosteroid injection is relatively rapid pain relief. This can improve sleep, reduce inflammation, and allow patients to participate more effectively in physical therapy.

Corticosteroids are not designed to heal torn tendons or structural problems. Repeated injections must be used carefully, particularly around the rotator cuff, as excessive use may affect tendon quality and future surgical outcomes.

Platelet-rich plasma

Platelet-rich plasma (PRP) is created from a patient’s own blood. The blood is processed to concentrate platelets, which contain growth factors and signaling proteins involved in tissue repair and inflammation regulation.

PRP is most commonly used for tendon-related shoulder conditions, including rotator cuff tendinopathy and partial-thickness tears. Some studies suggest PRP may improve pain and function in selected patients, although results vary based on preparation technique, diagnosis, and patient-specific factors.

PRP does not replace surgery when a tear is large, retracted, or functionally limiting. Its role is typically as part of a broader treatment strategy rather than a standalone solution.

Other biologic injection approaches

Additional biologic injection strategies are being studied in orthopaedics, including bone marrow–derived products, growth-factor–based therapies, and other regenerative approaches.

These treatments aim to improve the biologic environment around injured tissue, potentially supporting healing or reducing inflammation. However, the strength of evidence varies, and many of these approaches remain investigational for routine shoulder care.

The decision to consider a biologic injection depends on the diagnosis, imaging findings, severity of structural damage, prior treatment, and overall goals.

Choosing the right injection

The most important factor is not the type of injection—it is the accuracy of the diagnosis.

Shoulder pain may originate from the rotator cuff, biceps tendon, joint cartilage, capsule, AC joint, or even the cervical spine. The effectiveness of any injection depends on placing the treatment in the correct location for the correct condition.

In selected cases, image-guided injection can improve precision, particularly when the diagnosis is complex or when the injection is being used to confirm the source of pain.

What this means for patients

Injection therapy can be a valuable part of shoulder care when used appropriately. Some injections are designed to reduce inflammation. Others are intended to support healing biology. Some are used diagnostically to better understand the source of pain.

Not every patient benefits from injection therapy, and not every shoulder condition should be treated with an injection.

The goal is not simply to perform an injection—it is to understand the underlying problem and choose the treatment most likely to improve pain, restore function, and optimize long-term outcome.