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maria58274 maria58274

Hydrodilatation - my experience

I've decided to start another thread on here to document my experiences with Hyrodilatation (also spelled Hydrodilation or known as Arthrographic Distension) and how well it works for me over the next few weeks or so.

A brief background, in case anyone didn't read my original thread.  I started with odd pains in my shoulder in spring, this year, with no apparant cause and I assumed I'd just pulled a muscle or something like that and hoped it would go away on it's own.  It got worse over the summer and I also started to lose movement. I had the usual excrutiating pain on knocks or jerks and aches right down my arm.  Pain, lack of sleep and loss of movement finally drove me to the GP in September where I was diagnosed with a frozen shoulder.  I managed to seek physiotherapy with Bupa (or I'd still be on the NHS waiting list) and was recommended by a physio to see a consultant with a view to Hydrodilatation.

I had my Hydrodilatation this afternoon - 14th December.  A few hours on and I'm feeling fine.  I was very nervous but the procedure itself went well and took 15-20 minutes in total.  I'd worn a vest top, which meant I didn't need to wear a gown and just dropped my straps off my bad shoulder.  I was asked to lie on my front, with a pillow for support.  I'd thought the procedure was done via x-ray guidance but it was in fact ultrasound guided.  The doctor explained what was about to happen and did an initial scan of my shoulder area before giving me a local anaesthetic.  He then put in the needle for the hydrodilatation, which administered first some cortisone and then saline.  He said I might feel some pushing and to let him know if it became painful.  There was some discomfort but I wouldn't describe it as painful and within a few minutes, he said the saline had started to leak out of the joint and the procedure was over.  He did another scan and checked my movement before and after - there was perhaps a couple of degrees improvement but nothing drastic.  I left the hospital with a plaster on my shoulder and feeling fine.  He said I might experience a bit of aching once the local anaesthetic wears off but the cortisone should kick in within a day or two and should improve things pain-wise.

Physiotherapy is recommended within a few days of the procedure and I have an appointment with the physio on Friday morning and another to see the consultant again in about 6 weeks.  So far, so good but it remains to be seen how sucessful it has been in improving pain and getting my movement back.  I can currently lift my arm about 90 degrees in front, slightly less at the side and very little behind my back.

I will document my progress over the next few days and weeks, for anyone else considering this treatment.  Hope this information is of help to someone and fingers crossed that the procedure works for me!

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  • Lambchop2 Lambchop2 maria58274

    I don't know if you are talking about cortizone injections but plenty of us have had them and they do work great temporarily but eventually the pain comes back and surgery is necessary.  

    • maria58274 maria58274 Lambchop2

      Hydrodilatation is where a mixture of saline and cortisone is injected directly into the joint, under a certain amount of pressure and guided by ultrasound or x-ray to get into the right part of the joint.  Enough liquid is injected in to expand the joint in an attempt to disrupt the adhesions.  The cortisone is added to help but isn't actually an essential part of the process.  Quote from an explanation of the procedure:

      "The injected fluid can be seen to expand the joint and sometimes flow out of the joint in a particular direction. Distension of the glenohumeral joint with fluid is thought to disrupt adhesions (scar tissue), thereby opening or freeing up the joint allowing improved range of movement."

  • Lambchop2 Lambchop2 maria58274

    Sounds interesting but I can't see how saine can do the same job as a scalpel but good luck!! And keep us posted. It could work with a mild case of adhesions but if you have any other conditions that are contributing factors in the frozen shoulder such as rotator cuff tear and/or bone spur, the frozen shoulder would just come back. Let us know if your relief continues.

    • maria58274 maria58274 Lambchop2

      As far as I've been told, I have no underlying conditions.  My frozen shoulder started with no apparant reason and wasn't a secondary one, after an injury.  There is a certain amount of disagreement between some consultants as to how effective hydrodilatation is - as there is about most of the ways of treating frozen shoulders.  My consultant (a well qualified, shoulder specialist) claims very good results for it at his clinic with 90% getting improvement in pain relief and 70% in movement.  I'm happy to take his advice and hope I'll be up there in his successes.  Will report back on here, either way.

    • moira61832 moira61832 maria58274

      Hi

      I have just been diagnosed with FS and am on the waiting list for hydrodilitation . I am in so much pain, getting showered and dressed in the morning leaves me exhausted. It is good to read about how others have got on with the treatment. I am hoping to get my life back

    • elaine93514 elaine93514 moira61832

      I totally sympathise with you. This is my 2nd FS. My left shoulder was affected 3 yrs ago due to stretching awkwardly. This time its my right shoulder brought on by breaking my wrist.

      I am due to have hydrodilitation May 15th. I know whats ahead of me as I had it done 3 yrs ago so anything that helps get rid of this debillitating misery is a blessing.

      The pain, the stiffness, the lack of movement to do simple things like doing your hair, your bra etc is beyond belief.

      It will get a bit easier pain wise.

      I will keep you informed as to how my procedure goes.....are you on the NHS waiting list? Its chronic how much pain you have to put up with before they treat you but going private was out of my reach.

      Good luck & keep the arm moving as much as you can....I know the pain!!

    • jackie98217 jackie98217 elaine93514

      Hi, I have recently been diagnosed with FS, I had a cortisone injection 4 days ago with no effect, I have now been referred to an orthopedic consultant for review but I have been advised to research hydrodilitation, I was just wondering how successful it has been for you? And how long did it take for the movement to return, Its my right shoulder and I have had very minimal movement with excruciating pain in movement for over 5 months, really need a solution 

    • lyn123xmas lyn123xmas elaine93514

      Hi jackie

      I had hydrodialtion and within 3 weeks i have movement back except putting bra on but i excersized every 20 mins for 2 weeks

      But pain is still there

      Ive had fs since feb now waiting on steroid injection

      Hydrodilatation was very painful x

    • jackie98217 jackie98217 lyn123xmas

      Hi Lynne, 

      I'm sorry to hear the hydroditliation has not been completely successful for you, on a positive note, the pain has greatly reduced for me following the cortisone injection but the restriction on movement has not changed at all, hopefully when you have the injection you may be able to get back to normal, it is such a debilitating thing to have isn't it, I hope you get your injection soon x

  • pollmadoll64 pollmadoll64 maria58274

    Can I ask you where you had it done?

    • maria58274 maria58274 pollmadoll64

      If you search for shoulder doctor in Wilmslow, you'll find my consultant and the private hospital I went to.  He also practices at another private hospital in Cheadle (Cheshire) and does some NHS work at Wrightington.  I know from your other posts, this isn't really local to you but it might be worth travelling, if you can't find somewhere local.

  • maria58274 maria58274

    It's now Friday and I had my physio session this morning, so thought I'd report back.  No miracle cures at the moment - but at least I'm pretty much without pain, which is progress to me!  I believe some people experience the capsule releasing immediately during the procedure as the saline expands the joint - but mine leaked before this stage.  At the very least, I've had a guided cortisone injection into exactly the right spot.  I was told that for some people it can take a couple of weeks for things to improve, so will see if my stiffness progresses in that time.

    As expected, I had some aching when the local anaesthetic wore off but nothing too drastic, just a mild ache.  This has gradually worn off over the last couple of days.  There is now just an odd slight twinge on certain movements and if I try to push too far beyond my range but it doesn't hurt at all at rest and I can even lie on that side - for a short time at least.

    The physio seems to think I have gained a bit more movement since my last visit.  I told him that from my perspective, lack of pain was most important and I was happy to regain my movement slowly. He checked me out and did a bit of minor manipulation but basically said it's up to me now.  He's happy for me to carry on with the excercises at home and only need to go back to him if I have problems. He also worked some magic on my back which I think I pulled by doing everything so awkwardly!   I have a follow-up appointment with the consultant at the end of January, so will see how it is by then.

    Will report back if anything changes - in the meantime, I hope all of you have a peaceful Christmas and a pain-free new year!

  • claire50742 claire50742 maria58274

    Hi from Australia,

    I have been suffering for 6 mnths with this. Wow, I thought I was going to go mad. In dsigust at my GP telling me that I was letting it get to me, (no soid sleep for 6 mths nd not missing a day of work might I add) I changed GPs. I went to see a new one on Monday who ordered a CT scan of my neck. I have had an MRI of my shoulder and it showed a spur, bursitis, a small tear in my shoulder and frozen shoulder. He thinks that the intense pain is due to something going on in the neck. He has also recommended the treatment that you are discussing. Likewise, I feel I am desperate enough for nything right now. It will be the first CHristmas that I simply am to tired to bother with although with 2 small grandchildren I shall make an effort.

    How can something like this affect so much of your life? How can they look at you with an expression that almost says "another middle aged hormonal woman moaning about a sore shoulder"

    Perhaps I am simply over sensitive!

    Anyway - this wonderful new GP prescribed me Tramadol - one at night. I took it reluctantly last night and whoo hoo I had 3 hours of continuous sleep! Small steps forward finally!

    Wishing you well. Keep us posted!

    • maria58274 maria58274 claire50742

      Hi Claire, sorry to hear you are in so much pain.  Unfortunately, apart from the lack of movement, we don't look ill with a frozen shoulder.  It's no excuse for the behaviour of some GPs.  As for hormonal - I am convinced there is a link between a drop in hormones and the onset of frozen shoulders in women - there are too many anecdotal cases - it's surely worth some research.  

      My treatrment hasn't miraculously improved my shoulder movement (it does for some) - though I do think it's a bit better.  I suspect for me that slow and steady progress is more likely.  It has however left me largely pain-free, which for me is my main priority.

      Hope you get treatment that gives you some pain relief soon - we all know how painful it is and how desperate it makes you feel.  I'll also be spending my Christmas Day with 2 grandchildren (aged 3 and 10) so know how much that means to you.  Hope they help keep your mind off the shoulder, at least for a while.  Best wishes for a peaceful Christmas and hope you start to feel much better soon.  Take heart in knowing it WILL get better!

    • Lambchop2 Lambchop2 claire50742

      Well I am glad the pill gave you some relief but aren't they going to do something to treat your condition like surgery??  I had one surgery here in the States that fixed my tear and frozen shoulder and am fine now 9 weeks out.  What use is a pill that relieves pain for 3 hours but does not solve the problem???

    • claire50742 claire50742 Lambchop2

      Hi Maria and Lambchop2

      Yes I had a great Christmas day with both little ones taking my mind off the pain for a while. I intend to get something done. I am a teacher and need to work. I feel I have 6 weeks to make a start on some treatment. The thing is, it is aslow process here and although I am willing to pay to go private, the waiting lists are extraordinary, nothing seems to be a priority either....

      Like you Maria, I am certain the drop in hormones is linked to it. In my opinion, there is not enough research being made into this condition, whic, while not urgent or life threatening, is most debilitating.

      Claire

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