Painful Shoulder Treatment: NSAID Pills versus Steroid Injections
Shoulder pain can be quite debilitating. Think about everything the shoulders allow you to do during daily life. You can wash your hair, brush your teeth and feed yourself all because of these versatile joints. It is nearly impossible to do any of those activities without the use of your shoulders. So when shoulder pain starts, you might be very tempted to run to the doctor to get an injection. But do injections provide any better treatment than anti-inflammatory pills?
That question is important because injecting steroids into a joint like the shoulder comes with a variety of risks. Anytime a needle is puncturing the skin, there is a risk of infection. Sometimes the steroid medication can cause fluctuations in blood sugar especially in people with diabetes. Steroids also weaken tissues like muscles, tendons and bones; thus the number of joint injections is limited to only three or four per year. Keep all these risks in mind before racing to the doctor’s office for a shot.
The alternative to getting a corticosteroid injection is to take anti-inflammatory pills. Of course taking pills can be risky too. Those that use blood-thinning medication really cannot take anti-inflammatory pills because that would increase the bleeding risk. These pills can also lead to stomach ulcers and kidney failure if taken in excess.
Both injections and pills have certain risks associated with them, so which one is really a better treatment for a painful shoulder? Over a four to six week period of time, both seem to provide an equal amount of pain relief and improvement of function. Although a shot has more of an immediate effect and can quickly extinguish the fire of inflammation, the long-term benefits do not seem to be superior to the benefits found with taking anti-inflammatory pills. In certain situations, an injection may be the best treatment. For example, if your shoulder pain is extreme and greatly debilitating, you may need to put the fire out fast with an injection. In other situations, pills might be better. If you are a diabetic and the shoulder pain is slowly building, then anti-inflammatory pills might be the best treatment to start with. Your doctor will be able to help guide your treatment decision. (1) (2) (3)
Before you run to the doctor to get a shot, first consider some home remedies for shoulder pain like the over-the-counter anti-inflammatory medications, ice, and rest. If none of that is helping within a couple weeks, then you may need to talk to your doctor about whether or not an injection is right for you.
- Arch Phys Med Rehabil. 2014 Oct;95(10):1824-31
- Br J Gen Pract. 2005 Mar;55(512):224-8
- Cochrane Database Syst Rev. 2003;(1):CD004016
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.