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What happens if this doesn't work?

Shoulder impingement syndrome that does not go away with several months of rest, ice, and anti-inflammatory medications may require more treatment. The next thing that can be tried is an injection with a local anesthetic like the Xylocaine® that the dentist uses and a powerful anti-inflammatory steroid. These medicines are injected into the subacromial space. This is a very safe procedure. It is not terribly painful and sometimes a single shot can take care of the shoulder pain and swelling forever.

The reason that an injection is more effective than oral medications is that it allows doctors to deliver a higher concentration of a more powerful anti-inflammatory medication to the inflamed tissues than would be possible orally. Unfortunately, it is impossible to predict how long the effects of the medication will last. Some people find that the relief that they receive doesn't last quite long enough, or that the shoulder pain returns after a short period of time. Most doctors don't like to give more than two or three injections in the same joint. There isn't anything particularly harmful about having more than two or three injections, but in general, doctors believe that this is a sign that shoulder surgery will be required to take away the pain properly.

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