Hydrodilatation - my experience

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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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  • Posted

    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.  
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    • Posted

      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."

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  • Posted

    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.
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    • Posted

      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.
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    • Posted

      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

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    • Posted

      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!!

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    • Posted

      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 
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    • Posted

      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

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    • Posted

      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

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    • Posted

      Hi lyn123xmas, my ortho has recommended hydialation and vigorous PT.  I was wondering how it has worked for you.  This is my second frozen shoulder, my first one was into it 11 months before the second one.  I did pretty much nothing for the first and most of the pain is gone and ROM is better but far from perfect yet although I notice increased pain now that I have to use it much more due to the second FS.  Hope you have had great results!

       

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  • Posted

    Can I ask you where you had it done?
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    • Posted

      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.
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  • Posted

    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!

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    • Posted

      Hi Maria. I had Hydrodilatation last week - i have 2 frozen shoulders.  They did one shoulder last week and then the next day I had to start physio.  The physio told me to use a shoulder pulley and to take amitriiptyline for the pain.  At the moment I am only using cocodamol for the pain.  I don't know if I have pushed too far with the exercises but I am in agony.

      How did you get on with your physio?  What did they have you doing?  There's so much conflicting advice out there.  How are you now?  Thanks!  Denise

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    • Posted

      Hi Denise

      2 shoulders at once, sounds awful!   I didn't have much physio after the first one (a very badly frozen shoulder) - the physiotherapist showed me exercises to do at home, which I continued on a rather ad hoc basis.  These were all gentle exercises, stretches, etc, stopping if it hurt.   The physio I did before the first hydrodilatation did not help - in fact it often seemed to make things worse.  The procedure stopped  the pain after a couple of days - just leaving a little discomfort if I slept on that shoulder for a while.  My movement didn't return immediately but I gradually regained it over the following months.

      The second one (2 years later) was done at a much earlier stage, as I'd recognised the symptoms and I hadn't lost much movement.  I did have some physio after that - but again the excercises were gentle enough not to cause pain.  I had a great physiotherapist, known personally to my consultant and she'd had a frozen shoulder herself, so knew what I was going through.  A year on from that second procedure, I'm absolutely fine.  As far as I can tell, I have full movement and no pain.  It worked very well for me.

      There is a lot of conflicting information - and I'm no doctor - but from a personal perspective, I don't think physio that causes more pain is helpful and could even set you back.  Exercise by all means but keep it gentle, stopping if it becomes painful.  Good luck, hope you're soon on the mend.

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    • Posted

      Hi Maria

      Thanks for your very helpful and reassuring reply.  It's so so good to speak to someone who has been through this.  Not many people have heard of hydrodilatation (even my own GP, and other healthcare professionals I know as friends, had not heard of it) let alone been through it.  

      It's been a nightmare with both shoulders at the same time.  Agony!!!  My partner is doing everything (cooking, cleaning, washing my hair, helping me dress and even doing my work .... I'm a dance teacher!).  I'd had a minor issue with one shoulder late last year, went to a physio in Feb, and the exercises he gave me were the final straw - both shoulders seized up almost immediately (pure agony!!)

      I paid to see a private sports doctor in March and she diagnosed it and recommended hydrodilatation.  Thanks to my GP, they managed to get it done on my left shoulder last week through the NHS.  Almost immediately afterwards the shoulder felt looser and in less pain.   Not much change in range of movement but certainly less pain.

      The hospital had arranged a physio appointment for me for the following day.  The physio gave me exercises with a pulley for both shoulders.  He wasn’t impressed that I’d had the procedure done, as he believes he could sort out both shoulders through physio alone.  He really pushed me hard ... hence the agony I was back in yesterday.  

      I think you are right - I will do exercises ... but very very gently.  

      The problem with FS is that every healthcare person has a completely different view on it. I’ve had so much conflicting advice/info.  You end up battling not only with the pain/disability, but also with the doubt about whether the approach you have taken is the correct one.

      It really is so good to be able to speak to people who have been through the same thing.  No matter how much my family and friends try to help, they really don’t know how painful this is.  

      Thank you!!

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    • Posted

      Hi Denise, I too have two frozen shoulders!  The left one for 11 months and the right for about 6 weeks now.  I pretty much left the left one alone and the pain subsided after a few months and I gotten some ROM back.  I am noticing that the pain has come back a bit again in that shoulder as I had to all of a sudden pick up all of the slack with that arm once my right one went FS!  

      This time I went to an ortho who is recommending hydrodialation with aggressive PT.  My PT from Florida said best to rest it more than aggravate it and that it will get better on its own in its own time if I don't mess with it too much.

      What to do?  How are you doing? Thanks! 

       

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    • Posted

      I highly recommend hydrodilatation - I've had it done twice now, first on my badly frozen and painful shoulder and the second on my other shoulder which was done much earlier, as I recognised the symptoms.  I do NOT however recommend aggressive physiotherapy - gentle physio only, stopping if it hurts.  First time the procedure stopped the pain and I regained my movement over a few months with mainly home exercise.    The second time I hadn't lost much ROM - with the procedure and gentle physio, I was able to avoid the months of pain, lack of sleep, etc and stopped my shoulder from freezing further.  Good luck  and I hope you get the treatment you need.

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