Shoulder Steroid Injections
Ultrasound-Guided Cortisone Injections

A steroid (cortisone) injection in the shoulder is used to reduce inflammation and relieve pain from a range of shoulder conditions. It is one of the most effective non-surgical treatments, where pain is being driven by inflammation in or around the joint.

Common conditions treated include:

• Rotator cuff problems: tendinitis and impingement causing pain on lifting or reaching.
• Subacromial bursitis: inflammation of the bursa beneath the shoulder blade tip.
• Shoulder impingement: pinching of the tendons during overhead movement.
• Frozen shoulder (adhesive capsulitis): particularly in the early, painful stage.
• Shoulder osteoarthritis: wear-related pain in the glenohumeral or AC joint.

Because an ultrasound assessment confirms the exact location of the problem area, the injection can be targeted to the precise structure responsible rather than the shoulder in general.

A shoulder steroid injection tends to help people whose pain is inflammatory in nature and who have not had enough relief from rest, anti-inflammatory medication or physiotherapy alone.

Typical symptoms that respond well include:

• A deep ache in the shoulder or upper arm, often worse at night.
• Pain on lifting the arm, reaching overhead or behind your back.
• Disturbed sleep, especially when lying on the affected side.
• Stiffness or weakness that limits everyday tasks.

It is especially helpful as a way to break the pain cycle so that you can engage with rehabilitation and rebuild strength and movement. Your consultant confirms on the day, after an ultrasound assessment, whether an injection is the right step for your particular issue.

At the Harley Street Ultrasound Group, your appointment begins with a diagnostic ultrasound assessment, performed by your specialist consultant doctor. Ultrasound shows the tendons, bursa and joint in real time and is used to identify the exact source of pain. It just as importantly rules out other causes, such as a full-thickness rotator cuff tear or calcific tendinopathy, which may need different treatment.

Identifying the problem accurately first is what makes the treatment precise. Because the same ultrasound is then used to guide the injection, your consultant can place the needle exactly into the target structure, rather than by external approximations.

If the assessment shows that a different treatment would serve you better, your consultant will tell you on the day. (See “What if I don’t need an injection?” below.

A steroid injection in the shoulder is an ultrasound-guided cortisone injection that delivers a small dose of anti-inflammatory steroid, usually combined with local anaesthetic, directly into the subacromial space, a tendon sheath or the joint itself. The steroid reduces inflammation, which in turn relieves pain and allows movement to improve.

Because the procedure is performed under real-time ultrasound, your consultant can ensure the injection reaches the exact location and confirm the medication is going precisely to where it is needed. This precision is what makes the treatment both effective and safe, avoiding nearby nerves and blood vessels.

The local anaesthetic often gives early relief within hours, while the steroid’s anti-inflammatory effect builds over the following days. Other options your consultant may discuss, such as a PRP injection, are covered in FAQ 10.

Most patients find the injection far more comfortable than expected. Local anaesthetic is used, so you typically feel a small sting as it goes in, followed by a brief sensation of pressure. This is normal and settles quickly.

The appointment usually takes around 20–30 minutes from assessment to completion:

• Your consultant scans the shoulder to confirm the source of pain.
• The skin is cleaned and local anaesthetic is applied.
• The injection is delivered under live ultrasound guidance.
• You rest briefly and are given aftercare guidance before you leave.

There is no general anaesthetic and no overnight stay. You can usually drive yourself home, though arranging a lift is sensible if your shoulder feels sore afterwards.

Your injection is performed by a consultant specialist doctor, not a physiotherapist, nurse or GP. This matters, as the majority of MSK injections in the UK are delivered by non-consultant practitioners, often without ultrasound image guidance.

At the Harley Street Ultrasound Group, you receive both the clinical judgement of a senior specialist and the precision of real-time ultrasound examination in a single appointment. Your consultant assesses the shoulder, confirms the source of pain, performs the procedure and explains your aftercare personally.

We will never give you an injection you do not need. If, after your ultrasound assessment, your consultant decides an injection is not the right treatment for you, the procedure simply won’t go ahead. You will be charged at our standard diagnostic ultrasound rate, not the full treatment price.

This is a deliberate commitment to clinical integrity. Some providers treat every appointment as a guaranteed procedure; we don’t. You can book knowing that you will receive a genuine specialist assessment first, and that treatment only proceeds when a senior clinician believes it is genuinely warranted.

If an injection isn’t appropriate, your consultant will explain why and set out the alternatives. This may include physiotherapy, a different injection, such as PRP, or onward referral, meaning you still leave with a clear plan.

Many patients notice early relief from the local anaesthetic within hours, though this often wears off before the steroid takes effect. The anti-inflammatory benefit of the cortisone typically builds over a few days to two weeks and continues to improve from there.

How long the relief lasts varies with the underlying condition. For many people a single shoulder steroid injection gives several weeks to several months of meaningful relief, and for some the benefit is longer-lasting, particularly when the window of reduced pain is used to engage with physiotherapy and rebuild strength. Your consultant will give you a realistic picture based on your own assessment, and will advise on whether a repeat injection is appropriate if symptoms return.

There is no significant downtime. You can return to everyday activities the same day, though it is sensible to avoid heavy lifting or strenuous shoulder use for 24–48 hours to let the medication settle. You may experience some mild soreness for a day or two, and sometimes a short-lived “steroid flare,” which is normal and eases with rest and simple pain relief.

Side effects are uncommon and usually minor; your consultant will talk you through them on the day. The single most valuable part of aftercare is using the period of reduced pain to resume gentle movement and any prescribed physiotherapy, which is what turns short-term relief into a lasting improvement.

You will receive clear written aftercare guidance, and our team remains available if you have any questions as you recover.

Both are ultrasound-guided injections, but they work differently. A steroid (cortisone) injection reduces inflammation quickly and is excellent for settling an acutely painful shoulder. As a result, it is the usual first choice for rotator cuff pain, bursitis and impingement.

PRP (platelet-rich plasma) uses a concentrate of your own blood to support tendon healing rather than simply reducing inflammation. It is often considered for more chronic tendon problems, or where repeated steroid injections are not desirable.

The right choice depends on your diagnosis, how long the problem has been present and your goals. Your consultant will recommend the most appropriate option after the ultrasound assessment. You can read more on our dedicated PRP injection for shoulder page.

An ultrasound-guided steroid injection in the shoulder at the Harley Street Ultrasound Group is £525, all fees inclusive. There are no extra charges for the consultant assessment, the diagnostic ultrasound, the procedure itself, or your written report.

What’s included in the price:

• Consultant specialist assessment and diagnostic ultrasound
• Ultrasound-guided steroid (cortisone) injection
• Local anaesthetic and all consumables
• Written report and tailored aftercare guidance

There is no referral required and no waiting lists. Importantly, if your consultant assesses you and decides an injection is not clinically appropriate, you will only be charged at our standard diagnostic ultrasound rate, not the procedure price. We accept self-pay and most major UK private health insurers; please confirm cover with your insurer before booking.

Coming to us privately does not affect your NHS care. Our goal is to get you answers and treatment quickly, without the long waits often involved in accessing injection therapy on the NHS.

You are seen by a consultant specialist who can assess, diagnose and, where appropriate, treat your shoulder in a single visit. Your report and images can be shared securely with your NHS GP or any specialist, and if your situation needs onward NHS care your consultant will write to your GP accordingly.

We don’t want you waiting months in pain when effective treatment is available now.