Short Answer
At The London Ultrasound Clinic, we often see patients wondering if hydrodilatation is right for them. Hydrodilatation, also called hydrodistension, is a gentle and highly effective procedure. It stretches the shoulder capsule using a mixture of sterile saline, local anaesthetic, and steroid. This can reduce pain, improve movement, and support faster recovery from frozen shoulder (adhesive capsulitis).
Understanding Frozen Shoulder
Frozen shoulders can be frustrating. The shoulder capsule becomes inflamed and stiff, making even simple movements painful. It typically progresses through three stages: freezing, frozen, and thawing, each lasting several months. Pain and restricted movement can interfere with sleep, work, and daily life. While some cases improve naturally, recovery without intervention can take one to three years.
What Hydrodilatation Involves
At our clinic, hydrodilatation is performed under ultrasound guidance to ensure the fluid is delivered precisely into the joint capsule.
- The area is first numbed with local anaesthetic.
- A fine needle is inserted into the glenohumeral joint.
- A carefully measured mixture of sterile saline, corticosteroid, and local anaesthetic is slowly injected.
This gentle expansion of the capsule helps break down adhesions, restores elasticity, and allows the steroid to calm inflammation. The procedure usually takes less than 15 minutes, and most patients go home shortly afterwards with minimal discomfort.
How It Works
The injected fluid physically stretches the tight joint capsule, increasing space and helping to break down fibrotic adhesions. The steroid reduces inflammation and pain, while the local anaesthetic provides immediate relief. Patients are often able to begin gentle movement straight away, which is crucial for maintaining range of motion.
What to Expect After the Procedure
- Reduced pain and improved mobility can appear within days to weeks.
- Some mild soreness at the injection site or temporary discomfort during stretching is normal.
- Following a guided physiotherapy programme or structured home exercises is essential for long-term success.
Patients who follow a structured rehab plan usually maintain their range of motion and recover function faster.
Recovery and Long-Term Outlook
Hydrodilatation works best when combined with physiotherapy. Compared with steroid injections alone, patients often notice significant improvements in pain and movement.
- Functional recovery usually occurs within a few weeks, though full resolution can take several months.
- Most patients need only one session, though a repeat procedure may be considered if stiffness persists.
Is Hydrodilatation Right for You?
Hydrodilatation is generally considered for patients in the early frozen or stiff phases of adhesive capsulitis, especially if standard physiotherapy or steroid injections have not provided relief.
Each patient’s medical history, imaging, and stage of disease are reviewed to make a personalised recommendation.
References
- Quraishi NA, et al. Thawing the frozen shoulder: A randomised trial comparing hydrodilatation with steroid injection and manipulation under anaesthesia. J Bone Joint Surg Br. 2007;89-B(9):1197–1200.
- Jacobs LG, et al. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? Int J Clin Pract. 2009;63(9):1355–1360.
- Challoumas D, et al. Comparison of treatments for frozen shoulder: A systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581.
NICE. Hydrodilatation for adhesive capsulitis of the shoulder: Interventional procedures guidance. 2023.