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Several years ago, I had some injections into my knee to help lubricate it. The treatment worked and I've been able to put off a knee replacement ever since. Now my shoulder is acting up the same way. Can I get this same treatment for the shoulder?

You may be referring to the injection of a lubricating substance called sodium hyaluronate. Repeated injections of the hyaluronate have been shown to reduce pain, improve joint motion, and restore knee function. Studies have also shown this treatment given in weekly injections over a period of five weeks works well for the shoulder, too. Patients with adhesive capsulitis, otherwise known as frozen shoulder seem to respond well to this treatment. Patients with chronic frozen shoulder that have not improved with antiinflammatory medications or physical therapy may be the best candidates for this treatment. Ultrasound-guided injection is advised. This approach improves accuracy in the delivery of the injection. By the time the condition has become chronic, the joint capsule has shrunk and gaining access to the joint capsule is limited. The ultrasound images make it possible for the physician to make sure the hyaluronate reaches its intended destination. An alternate approach is with fluoroscopy, a 3-D real-time form of X-ray. Fluoroscopy also improves accuracy but exposes the patient to radiation. With improved technology, ultrasound devices (which have no harmful radiation) will probably replace fluoroscopy for these types of procedures. You'll need to see an orthopedic surgeon for an evaluation of your shoulder. Establishing the diagnosis is the first-step in determining the proper treatment. Whether or not you can benefit from hyaluronate injections into your shoulder will depend on the findings of the orthopedic examination.

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