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4 Causes of Shoulder Pain — And 3 Injections to Treat Them

4 Causes of Shoulder Pain — And 3 Injections to Treat Them

Have you ever thought about how often you raise or rotate your arm daily? There’s no way to avoid shoulder stress from repetitive movement due to everyday activities, sports, or jobs requiring overhead lifting.

This extensive movement makes shoulder pain a common problem. And once a shoulder injury occurs, you have a high risk of developing chronic pain or joint instability.

The experienced team at Cascade Orthopedics and Sports Medicine Center, P.C., has helped many people get relief from shoulder pain. They offer comprehensive care, including shoulder joint injections that promote healing and restore optimal strength and mobility.

Four causes of shoulder pain

There’s a long list of conditions and injuries that cause shoulder pain, but four common ones include:

Rotator cuff injuries

Your rotator cuff is a group of muscles and tendons that form a cuff around the top of your arm and shoulder joint. These tissues bear considerable stress as they stabilize the joint and lift and rotate your arm.

Everyday movement alone can cause overuse tears in the rotator cuff tendons. And if you’re active in athletics, the stress increases. As a result, many people end up with rotator cuff tears.

If the tendon doesn’t tear, it often becomes inflamed — a condition called tendonitis. Shoulder impingement (rotator cuff tendonitis) frequently affects athletes performing overhead activities, such as baseball, tennis, and swimming.


Your shoulder represents the third most common site of osteoarthritis. This degenerative disease develops as cartilage breaks down, causing inflammation, bone damage, and bone spurs.

Another type of shoulder arthritis, rotator cuff arthropathy, develops when the joint becomes unstable due to a rotator cuff tear. The damaged rotator cuff tendons allow the arm bone to move too much, rubbing against other bones in the joint and causing arthritis.


A bursa is a small, fluid-filled sac between soft tissues and bones. The sac creates a cushion that allows soft tissues (like your rotator cuff tendons) to glide over the shoulder bones without rubbing together. You can develop an inflamed bursa (bursitis) due to an injured tendon or repetitive movement.

Biceps tendonitis

Your biceps muscle has two tendons that connect to your shoulder. Biceps tendonitis occurs when the tendon attached to the top of the shoulder socket becomes inflamed and swollen. This condition typically develops gradually over years of shoulder movement.

Three injections that treat shoulder pain

At our practive, we begin with conservative treatments for shoulder pain, such as immobilizing the shoulder joint and physical therapy. We may also recommend a shoulder injection to relieve your pain or promote healing.

During all shoulder injections, we numb the injection site. Then we use ultrasound imaging to see inside the joint and guide the needle. Real-time imaging allows us to be precise in releasing medication to the targeted tissues.

When treating shoulder pain caused by the conditions mentioned above (and other causes of pain), we use injections containing:


Corticosteroids (steroids) are powerful anti-inflammatory medications. You may get significant pain relief from a steroid injection if you have any shoulder condition that causes inflammation.

Regenerative medicine

We perform platelet-rich plasma (PRP) and stem cell injections — regenerative medicine treatments that use your cells to heal injuries.

We make PRP by drawing blood and separating the platelets and plasma from the other blood components. To get stem cells, we use a hollow needle to withdraw a sample of your bone marrow which is a rich source of adult stem cells.

After isolating the stem cells, we inject them into your shoulder, using stem cells alone or combining them with PRP. Platelets and stem cells accelerate healing, rebuild new tissues, and reduce inflammation.

Hyaluronic acid

If you have shoulder osteoarthritis, you may need a hyaluronic acid injection. Your joints produce hyaluronic acid, a thick fluid that provides lubrication and absorbs shock. 

Injecting hyaluronic acid reduces inflammation, eases pain, and improves joint movement. It may also slow down the progressive damage caused by osteoarthritis.

Don’t wait to seek help for shoulder pain. In addition to relieving your symptoms, Cascade Orthopedics and Sports Medicine Center, P.C., can begin treatment that prevents progressive shoulder damage. Call us or use our online feature and book an appointment today at one of our offices in Hood River or The Dalles, Oregon.

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