Arthritis of the shoulder — the glenohumeral joint — causes pain, stiffness, and weakness that can limit everyday life. Where simple treatments haven’t worked, an intra-articular shoulder joint injection can reduce pain and help you get moving again. So what are the glenohumeral joint injection options for shoulder arthritis, and which works best?
What is shoulder arthritis?
The shoulder is the most mobile joint in the body — a ball (the top of the arm bone) sitting against a shallow socket on the shoulder blade, stabilised by the rotator cuff, the labrum, and the joint capsule. In arthritis, the smooth cartilage covering the joint wears away, leading to pain, stiffness, weakness, and a “crunching” sensation with movement.
Shoulder arthritis has several causes — wear-and-tear osteoarthritis, inflammatory arthritis such as rheumatoid disease, or arthritis following an old injury or dislocation.
When is a shoulder joint injection helpful?
A glenohumeral joint injection isn’t the first treatment for shoulder arthritis — it’s for cases that haven’t settled with simpler measures:
- Activity modification — reducing the movements and sports that aggravate the joint, such as tennis or heavy overhead work
- Physiotherapy — strengthening the muscles around the shoulder and shoulder blade to offload the joint
- Anti-inflammatory medication — tablets such as ibuprofen, used with care for their side effects
When these haven’t controlled the pain, an intra-articular shoulder joint injection is the logical next step — and it can also aid your recovery by allowing you to exercise more comfortably.
Why ultrasound guidance matters
The shoulder joint sits deep, close to important nerves, blood vessels, the biceps tendon, and the labrum. Placing an injection accurately — and safely — depends on seeing exactly where the needle is.
We perform shoulder joint injections under ultrasound guidance. This confirms the injection reaches the joint itself rather than the surrounding tissue, improves its effectiveness, and avoids the nearby structures. Studies show ultrasound-guided injections are more accurate than landmark-based (“blind”) ones.
What injection options are there for shoulder arthritis?
Cortisone injection
A cortisone injection is a powerful anti-inflammatory and the usual first choice. A recent study found a cortisone injection relieves shoulder arthritis pain for up to four months. It’s effective and quick-acting, but the relief is temporary, and we limit how often cortisone can be used in a single joint.
Hyaluronic acid injection
Hyaluronic acid occurs naturally in the joint and acts as a lubricant. A study found that injecting hyaluronic acid — such as Durolane — into the shoulder reduces pain for at least six months, and around 65–70% of people respond. It’s a good option where cortisone hasn’t lasted, or to avoid repeated steroid.
PRP injection
PRP (platelet-rich plasma) is prepared from your own blood and injected into the joint. While PRP has good evidence for knee arthritis, evidence for shoulder arthritis is currently limited, so we’re cautious about recommending it here.
Suprascapular nerve block
In some cases of shoulder arthritis, a suprascapular nerve block targets the main sensory nerve to the joint. It can be combined with a joint injection for more complete pain relief — a useful option in more difficult cases.
Which shoulder injection is best?
Weighing up the evidence, we suggest a simple cortisone injection first. If the pain returns, we recommend a hyaluronic acid injection such as Durolane, which tends to last longer. For difficult cases, a suprascapular nerve block can be added. Surgery — usually a shoulder replacement — is reserved for severe arthritis that hasn’t responded to any of these.
How much does a shoulder joint injection cost?
Dr Masci injects at a one-stop appointment — consultation, diagnostic ultrasound, and the injection in a single visit. At the Chelsea clinic (the most cost-effective location), a consultation with an ultrasound-guided cortisone injection is £400; hyaluronic acid is £470–£490 depending on the product; and a suprascapular nerve block and PRP are priced separately. Other clinic locations cost more.
See the full one-stop injection fees here, along with our clinic locations.
Frequently asked questions about a shoulder joint injection
How long does a glenohumeral joint injection last?
It depends on what’s injected. A cortisone injection typically relieves shoulder arthritis pain for up to four months, while hyaluronic acid (such as Durolane) tends to last at least six months. The effect isn’t permanent, so injections work best alongside physiotherapy and activity changes.
Which is better for shoulder arthritis — cortisone or hyaluronic acid?
Cortisone works quickly and is usually tried first. Hyaluronic acid tends to last longer and avoids repeated steroid injections, so we often move to it if cortisone hasn’t held. The best choice depends on your joint and how you’ve responded in the past.
Does a shoulder joint injection hurt?
There’s some discomfort, but ultrasound guidance lets us use a fine needle placed accurately, which keeps it brief. Some soreness for a day or two afterwards is normal.
Is a shoulder injection done under ultrasound?
Yes. The shoulder joint is deep and close to important structures, so we use ultrasound to place the injection accurately into the joint and avoid the nerves, vessels, biceps tendon, and labrum. Ultrasound-guided injections are more accurate than blind ones.
What if injections stop working?
If injections no longer control the pain, options include a suprascapular nerve block or, for severe arthritis, a surgical opinion about shoulder replacement. An injection can be a useful way to delay surgery, but it isn’t a cure for advanced arthritis.
Can I have a shoulder injection if I might need surgery?
Tell your surgeon. As with other joints, a cortisone injection close to shoulder surgery may raise the infection risk, so it’s best to leave a gap — see how soon after a cortisone shot you can have surgery.
Final word from Sport Doctor London about a shoulder joint injection
An intra-articular shoulder joint injection is a valuable treatment for shoulder arthritis that hasn’t settled with exercise and medication. We suggest cortisone first, then hyaluronic acid such as Durolane if the pain returns, with a suprascapular nerve block for difficult cases — all under ultrasound guidance for accuracy. Surgery is reserved for severe, unresponsive arthritis.
If you have painful shoulder arthritis, Dr Masci can assess you in London, including ultrasound in clinic. Contact the team here or call +44 (0) 203 488 0350.
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