Hydrodistension for Frozen Shoulder in Colchester, Essex

Frozen shoulder, or adhesive capsulitis, is a difficult condition characterised by pain, stiffness, and limited shoulder mobility. While conventional treatments like physiotherapy and corticosteroid injections are commonly used to manage symptoms, some cases require more advanced interventions. Hydrodistension, also known as hydrodilatation, has emerged as a promising treatment option for individuals with frozen shoulder.

Mechanism of Action

Frozen shoulder involves inflammation and thickening of the joint capsule, which leads to adhesions and restricted movement. Hydrodistension helps by mechanically stretching the tight joint capsule and breaking up adhesions, improving tissue flexibility and restoring mobility.

During the procedure, a mixture of corticosteroid, a large volume of sterile saline, and local anaesthetic (such as lidocaine) is injected into the joint capsule under ultrasound guidance. The fluid’s pressure expands the capsule, stretching the tissues and breaking down adhesions. The local anaesthetic also provides temporary pain relief, making the shoulder joint more comfortable to stretch.

This mechanical stretching triggers several physiological responses: it releases cytokines and growth factors that promote tissue repair, increases blood flow to enhance healing, and interrupts the pain-spasm cycle, reducing pain and improving muscle relaxation.

Hydrodistension Procedure Steps

1. Patient Preparation: The patient is positioned on an examination table, usually lying down. The shoulder area is exposed and cleaned to prevent infection.

2. Anaesthesia Administration: Local anaesthetic is used to numb the skin and tissues, minimizing discomfort during the procedure.

3. Ultrasound Guidance: Real-time ultrasound imaging guides the needle placement for precise injection into the joint capsule.

4. Injection Procedure: A needle is inserted into the shoulder joint under ultrasound guidance, and a mix of corticosteroid, local anaesthetic, and saline is injected to stretch the capsule and surrounding tissues.

5. Post-Procedure Care: After the procedure, the patient may experience temporary soreness. Ice packs and pain relievers can help manage discomfort. Patients are advised to avoid strenuous activity for a short period to allow for recovery.

Benefits of Hydrodistension Over Corticosteroid Injections

While corticosteroid injections are often used to treat pain and inflammation in frozen shoulder, they primarily address symptoms without targeting the underlying issue. Hydrodistension offers several advantages:

• Mechanical Stretching: Hydrodistension physically stretches the joint capsule and breaks up adhesions, directly addressing the cause of frozen shoulder and improving long-term mobility.

• Pain Relief: The procedure provides immediate pain relief through local anaesthetic, making the stretching process more comfortable.

• Minimal Side Effects: Hydrodistension is minimally invasive with a low risk of complications.

• Long-Term Improvement: While corticosteroid injections may offer temporary relief, hydrodistension has the potential for lasting improvements by addressing the root cause of the condition.

In conclusion, hydrodistension is an effective treatment for frozen shoulder, offering mechanical stretching of the joint capsule, immediate pain relief, and the potential for long-term mobility improvements. By addressing the underlying cause of adhesive capsulitis, hydrodistension provides a more comprehensive alternative to corticosteroid injections, helping patients regain shoulder function and improve their quality of life.