Subacromial corticosteroid injection

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I have been suffering with piriformus syndrome for the last year and the pain is excruciating. I have had several (over 8) injections of steroid, lidocaine and one of toradol. All of these injections have been done either under xtay in the hospital or under ultrasound in my Dr.’s office. Thay have not given much relief so i inquired about botox about 8 months ago. So i was referred to another Dr. In the same practice. I met with him 4 weeks ago and he thought i might get some relief with the botox. I was scheduled today and went in this morning. This Dr. Was going to have me lay on the table and give me a botox injection in my piriformus muscle. I asked how he was going to find it. He said by pushing to see where it hurt and then inject into the pirifomus till i told him where i feel the muscle jump. I told him i cannot tell by pushing on it. It doesnt hurt like that. Well he assures me that it takes skill to do these injections and he knows where the pirifomus muscle is. He left the room to mix my botox shot and i got even more nervous thinking to myself this is wrong. How is he going to be sure he’s injecting the right place and with botox of all things! When he came back i was almost in tears. I said im not so sure about doing this without ultrasound. I felt like an idiot and i was wasting his time. I apologized and said i would be more comfortable under ultrasound. He said he doesnt do ultrasound. So i decided to wait for the injection even though im in terrible pain. He said he would put my mixed needle in the fridge for next week so my other Dr. Can do it under ultrasound. My other Dr. Doesnt do botox injections so i dont know what will happen. This Dr. I saw today said that my original dr. Will give me a trigger point injection and i said ok but with the botox right? He said it doesnt matter whats in the needle. I said well ive been waiting for this botox for 8 months and of course it matters whats in the needle! Ive tried all the steroid and lidocaine etc and i want the botox to help ease my pain. He made me feel stupid. I know im not a dr but i believe that i made the right decision to not just let this man stick a needle full of botox in my butt without a 100% guarantee that it is in fact going in my piriformus muscle. I have no ides what he wrote in my file but he said that he agreed i shouldnt get the shot. Now i dont know if i insulted his intelligence by actions and words. So i have 2 questions for you #1 Do you think i made the right decision? And #2 will this mixed botox needle be ok in the fridge for a week till i can have the injection under ultrasound? Please respond to me. I am desperate and in pain and now im afraid that this Dr. Put some thing in my file that im paranoid or anxiety ridden. I was nervous today. I always am. I dont like needles. But i felt very torn today because i want that shot!

Your surgeon will look into the area called the subacromial space within your shoulder. This will be either directly through the arthroscope, or at pictures sent from the arthroscope to a monitor. They’ll insert specially designed surgical instruments through the small cuts and reshape this part of your shoulder blade. Your surgeon may also decide to repair any damaged tendons at the same time. This may mean your surgeon has to change from keyhole surgery to an open operation and will make a larger cut in your shoulder. See our FAQ on arthroscopy or open surgery below for more information.

The humerus, glenoid, scapula, acromion, clavicle and surrounding soft tissues make up the shoulder. There are three significant articulations: the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint. The glenohumeral joint is the most commonly dislocated major joint in the body.

Ligaments and surrounding musculature, including the rotator cuff muscles, contribute to shoulder joint stability. The rotator cuff is composed of the four muscles: supraspinatus, infraspinatus, teres minor and subscapularis that interlock to function as one unit. These muscles help with internal and external rotation of the shoulder and importantly depress the humeral head against the glenoid as the arm is elevated. The tendons join together to form one tendon, the rotator cuff tendon. This passes through the subacromial space. The subacromial bursa, which has a large number of pain sensors, fills the space between the acromion and the rotator cuff tendon. [ 1 ]

Subacromial corticosteroid injection

subacromial corticosteroid injection

The humerus, glenoid, scapula, acromion, clavicle and surrounding soft tissues make up the shoulder. There are three significant articulations: the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint. The glenohumeral joint is the most commonly dislocated major joint in the body.

Ligaments and surrounding musculature, including the rotator cuff muscles, contribute to shoulder joint stability. The rotator cuff is composed of the four muscles: supraspinatus, infraspinatus, teres minor and subscapularis that interlock to function as one unit. These muscles help with internal and external rotation of the shoulder and importantly depress the humeral head against the glenoid as the arm is elevated. The tendons join together to form one tendon, the rotator cuff tendon. This passes through the subacromial space. The subacromial bursa, which has a large number of pain sensors, fills the space between the acromion and the rotator cuff tendon. [ 1 ]

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