Injection blockade in the shoulder with diprospan for pain due to arthrosis of the shoulder joint, price at the Stoparthrosis clinic

A glenohumeral block is a procedure that helps eliminate the excruciating pain that is one of the leading symptoms of a disease known as glenohumeral periarthritis.

Our expert in this field:

Lashch Natalia Yurievna

Neurologist of the highest category, candidate of medical sciences, associate professor. Laureate of the Moscow City Prize in the field of medicine.

Call the doctor Reviews about the doctor

“Periarthritis” is a term that consists of two words: the Latin “peri” - “around”, and the Greek “arthros” - “joint”. The ending “-itis” means “inflammation.” Thus, it is easy to guess that “periarthritis” is an inflammation of the tissues that are located around the joint. The second word - “humeroscapular” - indicates exactly where the “sore” is located.

Content

Benefits of blockades for shoulder pain
How to perform a shoulder block
Treatment at the Stoparthrosis clinic

Expert opinion
Cost of shoulder block
We recommend reading

Pain levels

0 — 3

Mild pain

- does not interfere with everyday activities, but you can adapt to the pain.

4-6

Moderate pain

- prevents you from doing business, prevents you from concentrating, the patient remains independent

7-8

Strong pain

- it is impossible to carry out daily activities, it is difficult to think about anything other than pain, the patient cannot function independently

9-10

Unbearable pain

- requires urgent care, bed rest, disables the patient

What is used together with novocaine during blockade?

Since novocaine blockade is part of the treatment of the disease that caused the pain syndrome, other drugs are added to the novocaine solution:

Glucocorticosteroid hormones. Effective for chronic inflammatory processes. They have anti-inflammatory, immunosuppressive and antiallergic effects, reduce swelling.
Antibacterial agents. If severe pain occurs due to infectious processes, an antibiotic is added to the solution.
Medical alcohol. Alcohol-novocaine blockade is an effective method of treating severe pain. The solution is injected into the tissues surrounding the nerve endings, thereby innervating the affected area. This type of treatment is used for neuritis accompanied by chronic pain, inflammation or pinched nerves, and coccygeal pain that occurs against the background of degenerative changes in the spine.

Multicomponent blockade removes not only pain, but also its cause, so it produces a therapeutic effect

In addition to the blockade, for diseases of the musculoskeletal system, a neurologist can prescribe massage, physiotherapeutic procedures, drug therapy, including chondroprotectors, B vitamins, which improve metabolism in nerve fibers. A doctor from the SmartMed clinic draws up an individual treatment regimen after a comprehensive examination, when the cause of the pain becomes known.

Benefits of blockades for shoulder pain

Drug blockade is considered a very effective treatment. For administration, a combination of several drugs is recommended:

Blockade of the shoulder joint with diprospan and lidocaine is used most often; this injection helps to quickly relieve pain and reduce the inflammatory reaction. The effect lasts from several hours to several weeks; 3-5 blockades are recommended per course;
Shoulder injection with novocaine - used as local anesthesia for minor operations or to reduce a dislocated shoulder, the duration of anesthesia is up to 1-2 hours;

After injection, medications act directly in the affected area, depending on the disease, the effect is observed after 3-5 minutes:

inflammation and swelling of tissues decreases;
pain in the shoulder joint decreases;
mobility increases.

The effect of the blockade can last up to 2-3 weeks. As soon as the pain decreases, it is recommended to begin restorative procedures.

Scheme of blockade in the shoulder joint

Injection of diprospan into the shoulder under ultrasound guidance

Arthrosis of the shoulder joint;
Arthritis is inflammation of joint tissue;
Bursitis of the shoulder;
Rotator cuff tendonitis;
Tendonitis of the long head of the biceps tendon;
Synovitis is an accumulation of fluid in the joint cavity;
Periarthritis of the shoulder.

As a rule, the injection of the drug is carried out at one point where the pain is most pronounced. But for some diseases, they do a so-called three-point blockade, when drugs are administered into several areas. The method of administration and the number of injections are determined by the doctor depending on the patient’s condition and disease.

Types of novocaine blockades

Novocaine blockade can be local and segmental. The first is done at the lesion site, the second at the projection of the spinal segment.

Novocaine is administered intradermally, subcutaneously, intramuscularly and intraosseously. According to the technique of execution, the following types are distinguished:

Novocaine nerve block. Involves blocking nerve impulses. It can be perineural (anesthetic solution is injected into the area of the perineural sheath of the nerve trunk) and paraneural (into the tissue surrounding the nerve).
Therapeutic spinal blockade. The drug is administered paravertebrally, epidurally and articularly.
Case medicinal blockade according to Vishnevsky. The anesthetic is injected into the muscle sheaths. Used for traumatic damage to bone and muscle tissue.

Single-component and multi-component solutions are used. The former contain only a high concentration of novocaine, the latter contain auxiliary drugs that, in addition to pain relief, produce other therapeutic effects.

How is a shoulder block performed?

Relieving pain and reducing inflammation is the main task of the doctor. The most used and effective is blockade of the shoulder joint with diprospan or similar drugs - dexamethasone, Kenalog, hydrocortisone. Within 10-15 minutes after administration, the patient can raise his arm painlessly. Medicines are administered to the desired point after preliminary anesthesia with lidocaine or novocaine. After the blockade, an aseptic bandage is applied to the injection site.

Commented by Ph.D. traumatologist orthopedist Litvinenko Andrey Sergeevich:

Depending on the disease, a course is prescribed that includes the administration of several drugs. The interval between injections can be from 3 to 7 days. The shoulder block injection must be administered by a physician in a treatment room or doctor's office. The procedure can be carried out under ultrasound control for more accurate administration of the drug.

How is a medical shoulder block performed?

The technique of blocking the shoulder joint is determined by the attending physician. An anesthetic or hormonal solution is injected into the joint from the back, front or lateral side. When choosing a method for performing a drug blockade of the shoulder, the doctor takes into account the degree of damage to the joint, the type of injury or pathology. The procedure is carried out in compliance with all antiseptic rules in a small operating room, dressing room or treatment room. When providing emergency medical care (fractures, dislocations), it is allowed to perform a technically simple blockade outside the walls of a hospital facility.

The doctor treats his hands immediately before the procedure with antiseptic solutions, and first applies a 5% alcohol solution of iodine to the patient’s skin, and then 70% ethanol. Sometimes chlorhexidine bigluconate in the form of a 0.5% aqueous-alcohol solution is used for treatment. Sterile linen or dressing material is applied to the blockade area.

Before inserting the needle, the skin is wiped again with a sterile swab soaked in ethyl alcohol, and then slightly shifted to prevent the formation of a straight injection channel. To reduce the severity of pain, the skin is infiltrated with a thin needle with a solution of any anesthetic (Novocaine, Lidocaine). A so-called “lemon peel” is formed, through which a longer and thicker needle is inserted into the shoulder joint. Each of its advances is accompanied by an aspiration test - a manipulation necessary to ensure that the tip is absent inside the blood vessel.

At the end of the solution administration, the needle is removed and a sterile napkin is applied to the skin, secured with an aseptic bandage or bactericidal adhesive plaster. In some cases, a plaster cast or orthosis may be required.

Method of performing a shoulder joint block	Technique
Front	The patient lies on his back with his arm bent at the elbow. This joint should be in the frontal plane, so it moves slightly outward. When the patient is positioned correctly, the lesser tubercle of the humerus is clearly visible. Between it and the coracoid process of the scapula, a place is selected for inserting the needle from front to back
Behind	The patient lies on his stomach, and the doctor feels the posterior surface of the upper part of the acromion process, as well as the deltoid muscle located under it. It is here that there is a shallow fossa, bounded by the edges of the deltoid and periosteal muscles. A needle is inserted into the bottom of the fossa so that it moves towards the coracoid process
From the lateral side	The patient sits on the couch or lies on his healthy side with his arm extended along the body. The needle is inserted between the acromion process and the greater tubercle of the humerus bone

Treatment at the Stoparthrosis clinic

Before prescribing such an injection, the doctor must make sure that it is necessary. To clarify the diagnosis, further examination may be required - ultrasound or MRI of the joint. You can read reviews from our patients about the use of injections in the shoulder joint in the reviews section. Don’t waste time; if you have problems with your joints, immediately contact a professional.

or leave a request on the website.

Author of the article:

Litvinenko Andrey Sergeevich

Orthopedist

Make an appointment

Recent publications by the author:

Knee block
Heel spur block
Shoulder joint block
Wrist block

Pros and cons of novocaine blockade

Blockade injections of novocaine have the following advantages over other analgesic procedures:

quickly relieve pain;
the medicine is delivered to the source of pain, bypassing the bloodstream and gastrointestinal tract, so the negative impact on the body is minimal;
effective in cases where other medications do not provide the desired effect;
have low toxicity;
there are no side effects or complications;
have a wide range of effects, especially multicomponent solutions: eliminate spasm of muscle tissue and blood vessels, inflammatory processes.

Although novocaine blockade is the most effective and safe procedure for pain relief and reduction of inflammation, it has disadvantages.

The manipulation is complex and requires special conditions, experience and qualifications of the doctor. Incorrect actions can lead to serious consequences: damage to blood vessels, nerves, spinal cord, walls of internal organs, as well as secondary infection.

If the concentration of the drug is exceeded, nervous overexcitation is likely, which is manifested by convulsions, rapid breathing, and palpitations. Individual intolerance to novocaine and side effects cannot be ruled out.

Negative reactions occur rarely, in 0.5% of cases. These include:

fatigue;
dizziness;
headache;
decrease or increase in blood pressure;
nausea, vomiting.

The injection should only be given by a specialist in the field of neurology after examination, then the treatment will be safe and effective.

Therapeutic blockades are carried out by the attending physician

To make an appointment with a neurologist from the SmartMed clinic, you need to call @. Before the procedure, the doctor will conduct diagnostics, identify possible contraindications, and assess individual tolerance to the drug.

Our doctors

LITVINENKO Andrey Sergeevich
Traumatologist orthopedist Sports medicine doctor Experience: 19 years
Sign up
SKRYPOVA Irina Viktorovna
Physiotherapist rehabilitator Experience: 20 years
Sign up
MOISEENKO Alexey Yurievich
Traumatologist orthopedist Sports medicine doctor Experience: 17 years
Sign up
KHOLIKOV Timur Vyacheslavovich
Traumatologist orthopedist Sports medicine doctor Experience: 19 years
Sign up
Read also: Dr. Neumyvakin useful tips about arthrosis. Treatment method

Characteristics of Supraspinatus Tendonitis

Tendinitis of the supraspinatus muscle of the shoulder joint is a pathological process that is inflammatory in nature and is not caused by direct injury to this part of the body. The reasons that provoke damage to the muscle tendons in the shoulder area and further inflammatory and degenerative phenomena are excessive and prolonged loads on the proximal segment of the upper limb.

Thus, tendonitis of the supraspinatus muscle of the shoulder joint is localized in the area of contact of the tendon with the bone. This pathology can manifest itself against the background of other similar ailments, which include:

Inflammatory process in the area where the tendon joins the bone (enthesitis);
The presence of inflammation in both the tendon area and the location of the bursa (tenosynovitis);
Localization of the pathological process in the area of the bursae and articular cavities located in close proximity to the tendon.

As a rule, tendinitis of the supraspinatus muscle of the shoulder joint occurs after an inflammatory disease of the synovium or is preceded by bursitis.

Why do they contact us?

No queues
No need to wait, we work by appointment
All in one day
Doctor's appointment, diagnosis and treatment on the day of treatment
Let's relieve the pain
We will help you relieve pain in just 1-2 visits to us
We guarantee
Professional approach, affordable prices and quality
Doctor's appointment 0 RUB!
During course treatment all consultations are free
Three treatment options
We will select several options and offer optimal treatment

Effect

This procedure allows you to:

relieve swelling;
reduce inflammation;
relieve pain syndrome;
restore normal mobility of the shoulder joint;
give the patient the opportunity to undergo further examination using ultrasound of the shoulder joint or MRI of the shoulder joint.

It should be noted that joint blockade is only the first step in the treatment program. It helps relieve primary pain symptoms, but does not eliminate the root cause. Therefore, it is important that the patient, after undergoing a medicinal injection, fully follows the doctor’s treatment recommendations. Otherwise, the effect of the intra-articular block will be temporary, and the pain will return after 20-30 days.

Disease recognition process

Diagnostics is carried out comprehensively. To determine the extent of damage, experts use the following methods:

collecting medical history: recording complaints, determining the circumstances of occurrence, clarifying information about past pathologies and injuries, heredity;
external assessment of the joint: determination of range of motion and zone of maximum pain;
X-ray and CT: allow you to see the main visual symptoms (narrowing of the gap, growth, deformation);
ultrasound examination: assessing the condition of cartilage, ligaments, bones, joints and muscles;
magnetic resonance imaging: obtaining a visual image of the structures of the affected area;
laboratory blood test: identification of the inflammatory process;
arthroscopy: examining the inside of a joint using a camera inserted through a small puncture.

If the request is not primary, an appointment with specialized specialists is scheduled.

Symptoms and diagnosis

The main sign of the onset of the disease is pain.
It affects the muscles attached to the joint. Typically, patients complain of pain that occurs during certain types of stress (at the onset of the disease), as well as at rest and even at night (with chronicity of the process). Quite often, the disease occurs in representatives of professions whose work involves constant stress on the shoulder joint, and people actively involved in sports. Many people with shoulder periarthritis have osteochondrosis of the cervical spine. Diagnosis is usually relatively simple; characteristic complaints and simple diagnostic tests indicate the presence of an inflammatory process. To get a complete picture, your doctor may prescribe an x-ray or tomogram. It is important to distinguish between pain that occurs during periarthritis and arthrosis of the shoulder joint (which is sometimes mistakenly called glenohumeral periarthrosis). In the second case, changes in articular tissues are degenerative in nature and cannot be completely cured.

Indications for therapeutic drug blockades

Drug blockades in our neurological center are most often used for neurological diseases, which include complications of the cervical, thoracic and lumbar spine:

Tunnel syndromes, neuropathies - compression of the nerve trunk (blockades are especially effective);
Pain in the back or neck;
Pain in the spine due to intervertebral hernia;
Osteochondrosis;
Rheumatism;
Osteoarthritis of the joints:
Headaches (the crown of thorns blockade is effective)

The medical practitioner also practices drug blockades for other diseases as prescribed by a doctor. The neurologist determines the course of blockades individually for each patient. In each case, the blockade option and the drug are selected that guarantee an optimal, quick result.

Treatment of tendinitis of the supraspinatus muscle of the shoulder joint

Tendinitis of the supraspinatus tendon is characterized by a chronic course. It is possible to completely cope with the disease only if it is detected in a timely manner at the initial stage and strictly follows the recommendations of a specialist.

If supraspinatus tendonitis was diagnosed at the second stage, it is unlikely to achieve a 100% treatment result, especially if there is an accumulation of calcium formations in the tissues. But it is quite possible to increase the mobility of the shoulder joint and relieve pain at this stage of the disease.

If the signs of the disease are ignored, it can develop into an advanced form, which is accompanied by a complete loss of motor activity in the shoulder joint. In such situations, the only highly effective treatment method is surgery. But we should not forget about the long period of rehabilitation after surgery (can reach 3 months).

As for the initial stages of tendonitis of the supraspinatus muscle of the shoulder joint, at these stages conservative treatment may well give the expected effect.

It should be noted that in order to achieve a successful result with tendinitis of the supraspinatus muscle, it is better to focus on complex treatment, which involves the following measures:

Lifestyle changes;
Performing special therapeutic exercises;
Use of medications;
Compliance with dietary nutrition;
Carrying out physiotherapeutic activities.

If a patient is diagnosed with advanced supraspinatus tendinitis, treatment involves surgical intervention.

SWT for supraspinatus tendonitis

The shock wave method is particularly effective in eliminating this disease. This is a modern way to combat many pathological processes, which include calcific tendinitis of the supraspinatus tendon. In this case, it is possible to avoid surgical intervention and also obtain the following beneficial effects:

It is possible to crush calcium formations in the tendons;
Blood circulation improves;
The pain syndrome gradually disappears;
Metabolism is restored;
It is possible to quickly cope with inflammation;
Motor activity is normalized and tissue regeneration occurs.

The patient has the opportunity to achieve a successful and prolonged therapeutic result from the first sessions. Their frequency and frequency are determined individually. Even calcific tendinitis of the supraspinatus tendon can be cured using this technique, but the success of the procedures performed in 90% of situations is determined by the timeliness of a visit to a specialist.

In our medical center, highly qualified specialists who are fluent in the shock wave technique and use innovative Swiss equipment in their work will work with you. In this case, the first consultation with a doctor is carried out with a 20% discount.

Medications for supraspinatus tendinitis

Taking into account the results of the research, the specialist selects medications to cope with unwanted symptoms and eliminate the dangerous consequences of the disease. Below we provide a list of drugs that show effectiveness in treating supraspinatus tendinitis. These include:

Group of drugs	Therapeutic effect	Method of application
Anti-inflammatory drugs - Nimesulide, Dolgit, Ibuprofen, Voltaren.	They help eliminate swelling, relieve pain and cope with inflammation.	It is recommended to use it in the form of capsules, tablets, as well as gels and ointments.
Medicines that have an analgesic effect - Dexalgin, Ketonal.	They have the ability to eliminate severe pain.	Used in the form of intramuscular injections and in tablet form.
Drugs that prevent the destruction of cartilage tissue - Teraflex, Artra.	They allow you to restore cartilage tissue and prevent destructive-dystrophic processes in the joints.	Prescribed in tablet form.

It should be remembered that tendinitis of the supraspinatus and subscapularis muscles requires a qualified approach, and only a professional specialist can give recommendations on taking certain medications.

We employ high-level physiotherapists who approach problems with tendons and joints in a comprehensive manner, taking into account the individual characteristics of the progression of the disease.

How to treat supraspinatus tendinitis through physical therapy?

In order to increase the effectiveness of the treatment methods used, they resort to physiotherapeutic procedures. With their help, it is possible not only to cope with the signs of pathology, but also to increase the effectiveness of medications, as well as restore normal blood flow and improve cell nutrition.

At the same time, the most effective physical procedures include:

Exposure to shock waves (SWI). It is considered a highly effective way to eliminate calcific tendonitis of the supraspinatus muscle of the shoulder joint;
Application of ultrasound. Allows you to eliminate swelling and prevent the appearance of adhesions;
Electrophoresis. Ensures precise delivery of medications to the inflamed area;
Use of laser radiation. Promotes the restoration of tendon fibers;
Magnetotherapy. Allows you to normalize nutrition and blood flow in the affected area.

It should be borne in mind that physiotherapeutic methods of influence can be used only after acute processes have been eliminated.

Massotherapy

Restorative massage is recommended to eliminate pain. It allows you to relax muscle tissue and normalize metabolism. To achieve maximum results, it is recommended to undergo at least 15 procedures.

Dietary recommendations

When it comes to supraspinatus tendinitis and how best to treat it, the first step is to adjust your diet. Its principles should be aimed at strengthening tendons.

It is advisable to use	Not recommended for use
Beef meat, liver, fish	Sweet products, fast food
Eggs and dairy products containing beneficial bacteria	Carbonated drinks
Nuts, apricots, dried fruits	Alcoholic drinks
Lemons, oranges	Oatmeal
Green tea

Products recommended for consumption during the period of elimination of supraspinatus tendinitis contain large amounts of vitamins, as well as calcium, iodine, phosphorus and iron. This ensures rapid restoration of the elasticity and strength of the tendon.

In turn, prohibited products contribute to the rapid destruction of joints and tendons, and block the penetration of valuable substances.

Surgical treatment of supraspinatus tendonitis

If we talk about such a serious illness as tendonitis of the supraspinatus muscle of the shoulder joint, and how to treat it, then conservative methods are mainly used. Surgical methods are used in extreme situations, in case of tendon rupture. In this case, arthroscopic intervention is performed to minimize the risk of tissue injury. During this operation, pathological tissue is cut off, plastic procedures are performed with further strengthening of the tendon. A prerequisite after surgery is the implementation of rehabilitation measures.

Recommended Exercises

The need for therapeutic exercises is caused by the following goals:

Maintain motor activity of the joint;
Restore and increase the elasticity of the tendon.

In this case, it is recommended to perform the following exercises:

Rocking the limb back and forth;
Raising your clasped hands above your head. Number of repetitions – 5 times;
The right arm, located in a straight position, must be pulled to the shoulder joint located on the opposite side. The exercise is done in a similar way with the left limb;
Both upper limbs are brought behind the back and connected into a lock, held in this position for about 10-15 seconds. When repeating, change the position of the hands;
Using a gymnastic stick held in your hands parallel to the floor, you perform circular movements in the air. The total number of repetitions is 5 times;

To choose the most effective exercises, it is advisable to consult your doctor, who will select a special complex taking into account the degree of pathology. In case of acute pain, gymnastic exercises are not recommended.

Traditional methods

To eliminate the symptoms of the disease, you can use recipes whose effectiveness has been proven for centuries. They are aimed at increasing the strength of the tendon, improving its motor activity and relieving pain.

Below we will describe several folk methods that allow you to relieve the inflammatory process:

Walnut partitions. 1 glass of product is filled with 0.250 liters of vodka. The infusion period reaches 21 days. The mixture is taken one tablespoon 3 times a day;
Calendula flowers. The dried raw materials are crushed and 1 liter of vodka is added. The infusion time is 7 days. Compresses with this solution are applied to the affected joint. This helps to quickly relieve discomfort.

Lifestyle change

Experienced experts advise:

Avoid excessive stress on the upper limb and shoulder joint, avoid lifting heavy objects and active physical training. At the same time, it is not recommended to reduce the usual motor activity of the joint;
Avoid hypothermia. When exposed to any thermal irritants, the intensity of pain in muscles and joints may increase;
It is also necessary to stop drinking alcohol and using tobacco products, as this negatively affects the functioning of the entire body, including the shoulder joint.