Shoulder
Ultrasound-guided injection of the subacromial bursa
An anti-inflammatory medication is placed with ultrasound precision inside the inflamed bursa, reducing pain during arm movement.
How it is performed
The subacromial bursa is a small cushion allowing the tendons to glide beneath the acromion; when it becomes inflamed, lifting the arm becomes painful. Using ultrasound, the bursa is identified and the needle is introduced under direct visualisation, avoiding the tendons. A mixture of local anaesthetic and corticosteroid is then released. This is an ultrasound-guided procedure performed under local anaesthesia, through an access point of a few millimetres.
Who it is for
- Subacromial bursitis and impingement syndrome
- Shoulder pain during overhead movements
- Need to reduce pain in order to start physiotherapy
Recovery
No recovery time needed: daily activities resume immediately, avoiding intense effort for 48 hours. Benefit usually begins within a few days.
Conditions treated in this area: calcific tendinopathy of the rotator cuff, frozen shoulder (adhesive capsulitis), subacromial bursitis.
Scientific evidence
Randomised studies show that ultrasound-guided injection is more effective than a freehand injection in reducing pain and disability in chronic subacromial bursitis, thanks to more accurate medication placement.
References on PubMed
- Is ultrasound-guided injection more effective in chronic subacromial bursitis?
Hsieh LF, Hsu WC, et al. — Med Sci Sports Exerc, 2013 · PMID 23698243
- Ultrasound-Guided Standard vs Dual-Target Subacromial Corticosteroid Injections for Shoulder Impingement Syndrome: A Randomized Controlled Trial
Wang JC, Chang KV, et al. — Arch Phys Med Rehabil, 2019 · PMID 31150601
- The effect of injection volume on long-term outcomes of US-guided subacromial bursa injections
Klontzas ME, Vassalou EE, et al. — Eur J Radiol, 2020 · PMID 32540584
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of ultrasound-guided injection of the subacromial bursa?
It is an outpatient procedure performed with a thin needle under local anaesthesia and continuous ultrasound guidance, which makes it possible to see the needle, the target and the structures to avoid in real time. The most common issues are transient: pain or swelling for 24-48 hours, a small bruise. Joint infection is a rare event, prevented by sterile technique. In treatments with cortisone, facial flushing or a temporary rise in blood sugar may occur in diabetic patients. Personal risks and contraindications are assessed during the consultation.
How much does the ultrasound-guided injection of the subacromial bursa cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "how long does the benefit last?" and "can I repeat it?". The answer depends on the diagnosis and the stage: some injections resolve the painful episode, others serve to open a window in which rehabilitation becomes effective. Experiences read in forums concern cases different from yours. During the consultation we review your imaging and I tell you frankly what to expect, how many sessions may be needed and when another approach is better.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.