The shoulder contains various soft tissues. When inflammation develops for any reason, it causes shoulder pain. Anti-inflammatory injections are commonly used to eliminate inflammation. The purpose is to rapidly reduce inflammation and control shoulder pain. Among anti-inflammatory injections, the one with the strongest anti-inflammatory effect, lowest cost, and fastest pain relief is the steroid injection. This injection is also called a corticosteroid or adrenal cortical hormone. Generally, the steroid used for shoulder injections is a synthetic substance with a structure similar to the hormones naturally produced by our immune system.
Steroid injections have the fastest and most powerful anti-inflammatory effect among all anti-inflammatory agents, and when injected directly into the joint, they provide rapid inflammation relief and pain reduction. However, while steroid injections have excellent positive effects in quickly addressing shoulder pain, they also carry a significant downside — if improperly administered or overused, they can actually weaken soft tissues and the rotator cuff. For this reason, the government has established specific regulations regarding intra-articular steroid injections. The regulation states that same-joint injections should be administered at 2-4 week intervals, with a maximum of 4 times per year, and when multiple joints are treated simultaneously, no more than 2 joints are covered.
In other words, intra-articular steroid injections for the same area (shoulder, knee, wrist, etc.) are limited to 4 times per year. Why were such regulations established? There are two main reasons: side effects of the steroid medication itself and the nature of intra-articular injections. Long-term use of steroids can weaken bones, increasing the risk of osteoporosis, and can cause soft tissue deterioration. If steroid is injected directly into the rotator cuff or other tendons rather than into the joint space, the reaction can be more immediate and severe compared to surface contact through intra-articular injection.
The most important thing is to receive a proper prescription after medical examination and ensure the injection is administered accurately. Patients who respond quickly to steroid injections should pursue active rehabilitation and physical therapy rather than repeated injections to return to daily life. Steroid injections can quickly relieve joint pain caused by inflammation, but if the dosage and administration method are incorrect, they become poison. Steroid injections — a miracle cure when properly used, poison when overused — must be handled with care.
