Targeting your source of pain starts with a simple office visit. We will use simple in office exams consisting of strength, range of motion and an examination of your shoulders utilizing ultrasound. We can also utilize any existing radiological studies that you have had performed related to your pain/injuries. Shoulder pain is from one of four sources, including: impingement, tendinitis, rotator cuff injury, and arthritis. Once a diagnosis has been made, we can then discuss the options that are available for treatment.

The first option we will discuss are steroid with local anesthetic injections. These injections offer the fastest relief and are the most economical option. The steroid works quickly to reduce the inflammation within the joint and tendons while the local anesthetic provides almost immediate relief from the pain. The drawback with these types of injections, however, are the short duration of relief they provide as the symptoms return due to the defect still being present. These injections are often referred to cortisone injections.

Next, is PRP injections. PRP is an acronym for platelet rich plasma and is derived from the patient’s own blood after it is spun in a centrifuge. PRP is high in platelets, which release growth factors and various molecules that decrease pain and inflammation, while assisting the body to heal itself. Risks with PRP injections are low given the patient’s own blood is utilized. The procedure carries a very small risk of infection, just like with any type of injection.

Lastly, we will discuss stem cell therapy. Many recent studies have shown stem cells to be effective in treating joint and soft tissue injuries and improves pain and function in people with injuries to the shoulder. Stem cells can be obtained commercially from FDA monitored labs that ethically obtain the cells from Wharton’s Jelly, a protective coating from donated umbilical cords, or harvested from fat cells from the patient’s own body. The commercially obtained cells have been shown to be superior to patient harvested cells, especially in patients older than 60 years of age, but are a great choice for patients who want to use their own cells. Stem cells are undifferentiated, meaning they can mimic and become whatever type of cell the body needs in order for repair and regeneration. Like PRP, the procedure carries little risk and much fewer complications than surgery.  

Once a diagnosis is made and a treatment option has been chosen, the injection can be done as soon as the same day for steroids, local anesthetics, and PRP; with stem cells being as soon as two to three days from the initial appointment. Injections are performed utilizing the same ultrasound as in the diagnosis of the injury for precise delivery of the injectable into the area of injury, thus allowing for best optimal chances for recovery and regeneration of the damaged area. Plus, for use during your procedure, we offer nitrous oxide, as used in dental procedures, to decrease the discomfort and anxiety associated with joint and soft tissue injections. After the therapy is delivered you will be monitored shortly and may return to the comforts of your home the same day. We will follow up with you to ensure the effectiveness of the procedure and that there are no complications.