Frozen Shoulder Treatment
Shoulder Hydrodistension / Hydrodilitation / High Volume Injection
Hydrodistension, (also known as hydrodilatation or High Volume injection) is primarily used in the treatment of Frozen Shoulder. The procedure is performed under ultrasound guidance with the aim of precisely depositing anti-inflammatory steroid, local anaesthetic and saline (sterile water) to give pain relief whilst also deliberately stretching the lining of the joint (joint capsule). This procedure has been shown to be effective in the majority of patients by giving pain relief and also helping them to regain movement. These injections can give rapid and effective reduction in pain and inflammation; when coupled with immediate stretching exercises the effects can be maximised.
What happens during the hydrodistension procedure?
The clinician who will be performing your injection will choose the most appropriate steroid medicine and overall volume dose for your condition and symptoms. You will normally be lying down for the injection with the joint exposed. The clinician will inject under ultrasound guidance directly into the joint. Most injections are quick and easy to perform. Some patients opt to have a smaller dose steroid injection immediately after the hydrodistension injection into an area around the joint known as the ‘bursa’ – there is some research to support that this gives significant amount of further pain relief. Having this additional procedure can be discussed with you’re treating clinician on the day.
What happens after the injection?
Due to the local anaesthetic, some of your pain may be relieved shortly after the injection but will probably wear off after a few hours. It usually takes several days for the effect of the steroid to fully begin to work.You may wish to arrange transport home after your injection as we would not recommend for you to drive immediately after a hydrodistension procedure as some people may experience some post-injection discomfort due to the stretching of the joint. Occasionally patients may feel a little lightheaded immediately afterwards. We recommend patient’s stay in the waiting area for 20-30 minutes following the injection. You should try to avoid strenuous exercise for 3-5 days after the injection but try to perform some regular stretches as advised at the time of the procedure from 24hours after your injection.
Will I need another injection?
Most people only need one procedure. If you find the injection helpful, and you feel further injections are required, this may be repeated. We usually recommend a period of 1 month between these injections. We usually recommend no more than 3 injections into any one location within a 12 month period. Injections are most often used to provide a period of reduced pain in order to engage in exercise and rehabilitation.