Hydrodilatation is a therapeutic injection which involves injecting a combined mixture of steroid, local anaesthetic and saline solution into a frozen shoulder.
Hydrodilatation works by treating the inflammation and stretching the capsule of the joint, thereby helping to reduce the pain and improve the range of movement in the shoulder and allow a return to normal activities.
This therapeutic injection has proved to be highly successful in relieving the pain of a frozen shoulder in an out-patient setting taking around 20 – 25 mins to complete. Post-procedure, physiotherapy rehabilitation is vital to help improve range of movement in the shoulder once the pain from the inflammation has reduced.
Frozen shoulder is usually a clinical diagnosis made by your doctor, whereby there is a combination of joint capsule inflammation and the development of scar tissue around the joint, which together, can cause pain and restricted range of movement to the shoulder – hence the term “Adhesive Capsulitis’ (frozen shoulder).
Hydrodilatation involves injecting a mixture of steroid, local anaesthetic and saline into the shoulder joint.
You should take your normal pain relief medication an hour before your appointment and inform the radiologist if you are taking blood-thinning medication such as Warfarin.
An USS or X-ray is used to guide the injection and ensure it is administered in the right place. You will be given an injection of local anaesthetic to numb the area. Once it is numb, a mixture of steroid, anaesthetic and saline solution will be injected into the joint.
The procedure takes around 20 – 25 minutes in total. You may experience a little pain and a feeling of pressure due to the stretching of the shoulder capsule however this should ease fairly quickly after the procedure.
Afterwards you may have moderate discomfort but this will only last around half an hour. You will be able to go home after around 15-30 minutes but will need someone to drive you. Any numbness will last for a few hours and these effects should resolve by the following day.
You will be given exercises to do, to maximise the effect of the steroid injection and increase any movement you have regained. Around 90% of people experience a reduction in pain and 70% benefit from increased movement. In some cases the improvement is immediate but for many people it can take a few weeks to take effect. You will be given an appointment to see a physiotherapist a few days after the procedure to see how well you are doing.
If you are diabetic you should carefully monitor your blood sugar levels for 48 hours after the procedure as blood sugar levels and insulin requirements may transiently fluctuate for several days.
Risks from the procedure are very small but in rare cases you may develop an infection. If your shoulder becomes swollen and painful or you develop a fever you should seek emergency treatment. If you have developed an infection you will be given antibiotics and the joint may need to be washed out. In rare cases people can be allergic to the steroid. This may cause a rash that can last upto a week. In rare cases people may have a severe allergic reaction to the iodine.
If the procedure is unsuccessful you may need to have keyhole surgery or manipulation under anaesthetic.
