The most common shot for shoulder pain is a corticosteroid injection, which reduces inflammation and can relieve pain for anywhere from 3 weeks to 9 months depending on the dose and the underlying condition. But corticosteroids aren’t the only option. Several other types of injections target shoulder pain in different ways, and the right choice depends on what’s causing your pain, how long you’ve had it, and whether you’ve already tried other treatments.
Corticosteroid Injections
Steroid shots are the go-to for most inflammatory shoulder conditions: rotator cuff tendinitis, bursitis, and adhesive capsulitis (frozen shoulder). The injection delivers a powerful anti-inflammatory directly into the joint or the space around the rotator cuff, cutting inflammation at the source rather than relying on oral painkillers to mask it.
Higher doses tend to work better. A meta-analysis in the British Journal of General Practice found that steroid doses equivalent to 50 mg or more of prednisone were significantly more effective than lower doses, with the highest dose studied producing the strongest results. Relief typically lasts between 3 and 38 weeks, with most people noticing improvement within the first few days. The injection itself takes only a few minutes and is usually done in an office visit.
There are limits to how often you can get steroid shots. Guidelines from the American Academy of Family Physicians recommend no more than four injections per year in the same joint. Repeated use can weaken tendons and accelerate cartilage breakdown over time. The needle should never go directly into a tendon because of the risk of rupture. Other possible side effects include a temporary flare of pain for a day or two after the injection, skin lightening at the injection site, and mild soft tissue thinning.
Who Should Avoid Steroid Shots
Steroid injections are off the table if you have an active infection near the injection site, an infected joint, a fracture, or a prosthetic shoulder joint. For people with diabetes, there’s an additional concern: the steroid can spike blood sugar significantly. Some practitioners recommend against injecting patients whose fasting glucose is above 200 to 250 mg/dL because of the risk of severe hyperglycemia. If you have diabetes, your doctor will likely want to monitor your blood sugar more closely for several days after the shot.
Hyaluronic Acid Injections
Hyaluronic acid is a gel-like substance that naturally exists in your joint fluid. When injected into the shoulder, it works as a lubricant and shock absorber, reducing friction between the bones. It also appears to have a protective effect on cartilage. This type of shot is primarily used for shoulder osteoarthritis rather than tendon problems.
The evidence is mixed but generally positive. Studies have shown improved pain and function lasting up to 6 months after treatment, and one comparative study found that hyaluronic acid produced better and longer-lasting effects than corticosteroids in patients with shoulder arthritis who still had an intact rotator cuff. That said, the American Academy of Orthopaedic Surgeons has stated there’s no clear benefit over other treatments, calling it added cost without additional gains. The most common side effect is temporary joint pain for a few days after the injection.
Hyaluronic acid may be worth considering if you have shoulder arthritis and haven’t responded well to steroid shots, or if you’ve hit the limit on how many steroid injections you can safely receive in a year.
Platelet-Rich Plasma (PRP)
PRP injections use a concentrated portion of your own blood. A small blood draw is spun in a centrifuge to separate out platelets, which contain growth factors that promote tissue healing. The concentrated platelets are then injected into the damaged area of your shoulder.
PRP is most commonly discussed for rotator cuff injuries and is sometimes used alongside surgical repair. Orthopedic surgeons have increasingly adopted PRP and another regenerative option called bone marrow aspirate concentrate (BMAC) as add-ons to rotator cuff surgery. Current research hasn’t shown that combining PRP with BMAC produces better functional outcomes than BMAC alone, and the overall evidence base remains small. Only a handful of high-quality studies exist, which means the benefits are still uncertain for many patients.
PRP is typically not covered by insurance, and costs can range from several hundred to over a thousand dollars per injection. It’s generally considered when other conservative treatments have failed or as a complement to surgery rather than a first-line option.
Nerve Blocks
A suprascapular nerve block targets the main nerve that supplies sensation to your shoulder joint. Rather than treating inflammation or cartilage damage, it interrupts pain signals. This approach has been used since 1941 and works for a wide range of shoulder conditions, including inflammatory arthritis, rheumatoid arthritis, adhesive capsulitis, rotator cuff tendinitis, bursitis, degenerative disease, and chronic pain after surgery or stroke.
Nerve blocks can provide both short-term and extended relief. For longer-lasting results, a small catheter can be placed near the nerve to deliver a continuous flow of numbing medication. This type of injection is more specialized than a standard steroid shot and is typically performed by a pain management specialist or anesthesiologist.
Hydrodilatation for Frozen Shoulder
If your shoulder pain comes from frozen shoulder (adhesive capsulitis), hydrodilatation is a targeted procedure designed to stretch the tightened joint capsule. Under ultrasound guidance, a mixture of steroid, local anesthetic, and saline is injected into the joint, with total volumes ranging from 10 to 40 mL depending on what you can tolerate. The fluid pressure physically expands the capsule, helping restore range of motion.
A prospective study found that patients improved by similar amounts regardless of whether they received lower or higher injection volumes, with meaningful gains in shoulder function scores at about 13 months of follow-up. The procedure is typically done as a single session and can be combined with physical therapy afterward to maintain the mobility gains.
Ultrasound Guidance Makes a Difference
How the injection is delivered matters almost as much as what’s in it. Ultrasound-guided injections, where the doctor watches a real-time image of the needle entering the joint, are significantly more accurate than landmark-guided (or “blind”) injections for most shoulder targets. For the AC joint at the top of your shoulder, ultrasound-guided accuracy is about 94% compared to 68% without imaging. For the main shoulder joint (glenohumeral), accuracy jumps from about 73% to 93%. The biggest gap is at the biceps tendon sheath: 87% accuracy with ultrasound versus just 27% without it.
Higher accuracy means the medication actually reaches the intended target, which translates to better pain relief. If you’re given the option, ultrasound-guided injection is worth requesting, particularly for smaller or harder-to-reach areas of the shoulder.
What to Expect Afterward
For most shoulder injections, plan on resting your arm for the first 24 hours. This gives the medication time to absorb and lets you monitor for any adverse reactions. After that initial rest period, you can gradually increase activity. Sports medicine specialists recommend 1 to 2 days of relative rest followed by a progressive return to normal use. You might feel some soreness at the injection site or experience a brief flare of pain before the medication kicks in, particularly with steroid shots. Full benefit typically develops over several days.
Ice applied to the shoulder for 15 to 20 minutes can help manage any post-injection discomfort. Avoid heavy lifting or overhead work for the first couple of days, and let increased pain be your guide for when to pull back on activity.