Hydrodistension is an injection to treat a common condition called a frozen shoulder also called adhesive capsulitis. But what is a hydrodistension and do you need one?

What is a frozen shoulder? 

frozen shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition causing pain and stiffness in the ball and socket joint.  It can develop over time and leads to a loss of functional use of the arm.

Generally, this condition is more common in women and people over 40. Also, conditions such as diabetes and hypothyroidism increase the chances of developing a frozen shoulder. Common shoulder conditions such as rotator cuff tear, dislocation or calcific tendinitis can lead to frozen shoulder.

Symptoms of Frozen Shoulder 

Usually, people who have a frozen shoulder report pain throughout the shoulder and restriction of movement. Often, simple activities such as reaching overhead, undoing a bra strap, or putting on a belt can be extremely painful. Also, pain at night is typical and often disrupts sleep.

Restricted movement is not due to weakness of the shoulder muscles but rigidity of the capsule. We think that the capsule becomes inflamed and rigid. So not only can you not move your shoulder; but if someone else tries, they won’t be able to move it either.

In general, most cases of frozen shoulder improve without treatment. However, waiting for this condition to get better spontaneously can take a few years. So, you’re wise to consider seeking treatment rather than waiting for it to get better.

What should your doctor do?

If you think you have a frozen shoulder, it is important to see your doctor to confirm a diagnosis. Unlike other conditions, frozen shoulder presents with a reduced range of motion. Also, we use imaging tests such as X-ray or MRI to exclude other causes such as arthritis.

If you can pick up and treat frozen shoulder in the early stages, you may be able to stop it from getting worse.

What treatments are available for frozen shoulder?

In the early stages, exercise can help improve the range of motion. Your therapist can teach you what exercises to do and what movements to avoid. Also, hands-on manipulation of the joint will help.

Anti-inflammatory tablets and pain relievers such as ibuprofen and codeine can help to reduce pain and allow you to continue with the exercises.  In some cases, cortisone injections into the shoulder can help.

Injections for frozen shoulder including hydrodistension

steroid injection in shoulder

Generally, cortisone injections are useful in the early or freezing stages due to reduce pain and stop the progression. We have good evidence that an injection can reduce pain for up to 4 months. It is important that injections are performed with ultrasound to improve the accuracy of the injection.

Hydrodistension, also known as shoulder joint distension, is a special type of injection using a high volume of water with a cortisone injection. We think that injecting a high volume into the joint leads to a build-up of pressure and a faster ‘thawing out’.

Is a hydrodistension better than a simple injection? 

The simple answer is probably. We have some evidence for hydrodistension. Previous high-level studies showed little effect of a hydrodistension compared to a simple cortisone injection. However, a recent study says that hydrodistention works much better. 

Importantly, these injections are done as a ‘one stop’ injection solution.

Final word from Sportdoctorlondon

Frozen shoulder is common in middle-aged people. Most cases do not have a triggering factor. Generally, hydrodistension works well to stop the progression of frozen shoulder.

Other common shoulder conditions:

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.

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