Injections do nothing but reduce the inflammation in your shoulder. They will not heal anything and the effect will only be temporary. Eventually you'll be right back to where you started. I never got more than a few weeks relief from cortisone injections. Your subacromial space is not going to get wider and if you have a rotator cuff tear it will never go away. If it were me (which it has been several times) I would go straight to the MRI w/arthrogram and then take it from there.

When/if to have surgery will be left entirely up to you. It will likely come down to how long you want to deal with the pain you're in when you know it will never go away.

Michael, Thanks for reply.
I have since had 2 cortisone shots, the first didn't do a thing but the second (into my AC joint area)has given me alot of pain relief (so far), although I am still sceptical that it will give me the 100% recovery I need to get back to daily life.
He has mentioned that he won't be giving me any more injections as I am reaching the scan/surgery stage as it's been going on so long but at what point should I be going down this next route? I am concerned the injections just cover up an injury and by leaving it with a little bit of pain may be making things worse?? If there is an improvement with these shots but am still in some discomfort, is this still reason enough to be seeing a surgeon??

Thanks

So far you've described classic "aging" of the shoulder (impingement).

The next step is to see if you can get by with just cortizone, if not, get an MRI arthrogram.

After that, possible surgery, but your shoulder surgeon won't want to do that for another 3-4 months (if you got pain relief from the injection, maybe more like 4-6 months).

I have had ongoing problems with my shoulder and a recent xray has shown "narrowing of the subacromial space with suspected underlying rotator cuff pathology".
I think I injured my shoulder skiing last year after falling during a ski lesson although didn't present itself until December and have been in pain everyday since.
My shoulder cracks badly and get pain in the front of my shoulder and down my arm (all the symptoms of the above). My GP has put me on anti-inflammatories and they haven't worked, I have just had my first injection into my shoulder which has eased it quite a bit but may need another. I am worried that these injection's won't do the job 100%. I have had it for 3 months solid now, what is normally the next step after this? Also, is it normal to get a few pins and needles now and then in fingers and a sharp pain on the back of the rotator cuff (above shoulder blade area)??
Is this a sign of a tear?