Pain Management Procedures
Subacromial-Subdeltoid Bursa Injection
Subacromial-Subdeltoid Bursa Injection
What is it?
The subacromial-subdeltoid bursa is a thin, fluid-filled cushion between the rotator cuff and the bone and muscle above it. When irritated, it can contribute to painful reaching, lifting, and sleeping on the affected side. A bursa injection places medication into this space rather than into the shoulder joint itself.
When may it be recommended?
It may be considered for shoulder bursitis, impingement-type pain, or pain associated with rotator-cuff tendinopathy or a tear. The injection can reduce inflammation but does not repair a torn tendon. Examination, ultrasound, or MRI may help distinguish bursal pain from joint arthritis, cervical nerve pain, or another shoulder problem.
What happens?
You sit or lie with the shoulder positioned for access. Ultrasound can show the bursa, rotator cuff, and needle in real time. The skin is cleaned and numbed; the needle is placed in the bursa, and local anesthetic with or without corticosteroid is injected.
What should I expect?
The shoulder may feel temporarily numb or heavy. Soreness or a steroid flare can last a day or two. Longer relief often begins over several days. When pain allows, guided exercise is usually important for restoring shoulder mechanics and strength.
Important risks
Risks include bleeding, infection, medication reaction, temporary blood-sugar elevation, skin thinning or color change, and tendon weakening with repeated steroid exposure. Contact the office for fever, increasing redness, drainage, or pain that continues to worsen beyond the expected short flare.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.