Hydrodilatation - my experience

Posted , 76 users are following.

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

    Oh bless I know only too well the pain you are going through.

    I was in pain a few weeks after the procedure but it did ease gradually.

    I did my exercises twice a day & I can now raise my arm up fully & to the side.

    However putting my arm up my back is still painfull. I probably have about 50% movement but I wnt give up.

    I think doing your exercises every 20 mins is way too much tbh. You need to ease up & start doing them about 2-3 times a day.

    Keep up with painkillers as these take the edge off but ease off as you feel much better.

    Good luck, it is painful but you will get there.

  • Posted

    Hi Maria.  Please keep us updated on your progress. Had an MUA just last Fri, and started PT today.  My ROM is similar to yours.  So I will be very interested on your progress.  Hope it will be good!
    • Posted

      Hi - was this adressed to me or to one of the other more recent posters on this discussion- it's easy to reply to the wrong person?  I started this thread in December 2015, when I had my first hydrodilatation (I've never had MUA) and reported progress, as it went.  Had a second hydrodilatation in my other shoulder 6 weeks ago - this time done much earlier, before I'd lost most of my ROM.

  • Posted

    ive not been excersing as much today last nite was so bad im so fed up with it and its driving me insane

    i have bursitus in both shoulders as well as fs in the right

    my left isnt great either and im worrying thats going to freeze

    my mum has a fs and alsways suffered with her shoulders i cant bear this any more

     

  • Posted

    Hi Maria

    Are you frozen shoulder free now?

    I am going through one now and would like to know how did it help you to get rid of it?

    The frozen shoulder on my right shoulder got fix after 2 long year. But now it's my left shoulder turn, yeah, without not reason just start acting up and it's frozen. ..and again don't want to 2 years later again

  • Posted

    Hello Maria

    ?As many have, I have read about your experiences and other correspondents with interest. I have a fs in my right shoulder (dominant arm). Have done for the last 5 months or so. I am diabetic (for 20 years or more) and (for my sins) a dart player - something that I have had to give up on in recent months. Night pains and the lack of sleep, in particular, are hard to deal with. I have had three steroid injections which have had the effect of numbing the pain for a period of time, but dont seem to loosen up my shoulder enough to have had a significant impact. Also I spent a significant period of time under an NHS pt followed by a private pt, who was actually the first person to diagnose the fs. I still undertake the exercises that I was recommended (with little obvious improvement) but dont visit a ps currently.

    My question relates directly to what stage I should be pushing my GP to refer me for treatments such as Hydrodilation and MUA (maybe hypnotherapy also)? Also to whom I should request referral (hosital orthopaedic specialist perhaps)? My GP indicates that I am still in stage one of three and that certainly MUA would not be considered until much further down the line. Experiences from people on here suggest that is not the case and that the earlier you get referred the better. Would that be your experience?

    My GP's focus seems to be on pain relief and continually ramping up my pain killers to try to find something that works for me (tried co codomol, tramodoland and now oramorph - none have worked to any great extent). I have been prescribed sleeping pills also, but I didnt like the way they made me feel the following day, so I avoid them.

    My conclusion is that painkillers are not doing it for me and that I need a treatment that eradicates the problem rather than taking my medicine and waiting for the exercises to have an effect. But I would be grateful for advice on the next stage and who I need to see to move to the next stage.

    ?

    • Posted

      Sorry to hear you are suffering from this awful condition - unfortunately I think that being a diabetic makes frozen shoulders more likely and adds complications to the treatment.  I've also heard that MUA shouldn't be done to early, or the shoulder may just re-freeze - but in any case, I wouldn't have considered this or any other sort of surgery.  I went for hydrodilatation, as it seemed less intrusive, didn't involve general anaesthetic or a hosptital stay.  For me it worked well in terms of stopping the pain and I was then able to regain my movement gradually.  The second time round (other shoulder) I chose to have the same treatment much earlier  as I recognised the symptoms and was advised by mu consultant  that for this treatment, the earlier the better.

      I think one of the issues for diabetics is the tolerance of cortisone - though you say you have already had steroid in injections.  There is a big difference between the kind of cortisone injection given by a GP and hydrodilatation, which is guided right into the joint along with saline (under a degree of pressure) to expand the joint.  Whether this is suitable in your circumstances would need a specialist to advise.  There are plenty of consultants that specialise in shoulder injuries and conditions and that's what you need to request to see.

      Good luck - hope you manage to get treatment that works for you.  let us know how you get on.

  • Posted

    Hello All,

    Kevin from Australia. I have had three hydrodialations in the past (back in 2014). After an MRI today I am going for my forth almost two years later. My shoulder was injured by a door and I can tell you each one of these procedures worked for me. Feel free to ask me any questions. Happy to discuss.

    • Posted

      Hi Kevin,

      I too have had hydrodilitation twice, 1st one 2 yrs ago worked well then again 3 months ago. Not so good this time but its all to do with a badly broken wrist. Could not do enough physio on my wrist bcoz of FS. Its about 75% better & I can move my arm but not like my other.

      It is something I would recommend to ppl myself, short discomfort during procedure but worth it to be rid of the agonising pain. Im from Uk btw..

    • Posted

      Hi Kevin, I'm wondering how you are now.  Why did you feel the need to have another hydro 2 years later, are you still in pain or lack of ROM?  

      I have FS in both shoulders, the left one started 11 months so the pain has subsided a lot, ROM slightly improved with having done nothing.  Now I was just diagnosed with FS in right shoulder, and my ortho is recommending hydrodialation.  Did they do yours with an ultrasound guiding it, and was the injection from the front or the back?  Thanks!

  • Posted

    Hi Maria

    I am new to this forum but have just had hydrodilatation for my FS a week ago. Had this privately as NHS waiting list too long and I need to be able to drive again asap as my husband is having chemo.

    The procedure itself wasn't too bad and I saw the physio last Friday who gave me some gentle stretching executes to do 5 times a day. Did these for 4 days, but today (day 5) they were a lot more painful - especially the one where you put your arm behind your back. Now my shoulder is really quite sore - although my range of movement has improved. Is this pain to be expected and has anyone else experienced this? It's not the constant pain I had before, just when I try to do certain things - e.g. carry a mug of tea, brush my teeth and do the behind the back execercise (that's really quite painful). Should I bite the bullet and persist or take it easy for a while? 

    Any advice would be most welcome!

    • Posted

      You may find a difference of opinions on this but from my personal experience, I'd ease off for a day or two, 'til it settles down - I don't think the no pain no gain helps and can make things worse.  The main thing I avoided, after both my procedures, was carrying anything too heavy, which could make my shoulder ache a bit - but it usually went back to normal after a day or two of rest.  Though physio does help in getting back your movement, I think that gentle, slow and steady is the best approach.  

      The best and easiest way I found of getting the movement behind my back was in the shower.  When you are wet and soapy, grab the hand of your bad arm with your good one and guide it round in circles, one way and then the other.  The slippy-ness and warm water helps and with a few rotations each day, you'll gradually find it moves further and better.

      Good luck and hope you're soon feeling better.  Let us know how you get on.

    • Posted

      I agree with Maria that doing the exercises in a warm shower seems to be the best place when doing them at home. As far as exercises go, if you can reach your arm behind your back you're already way ahead of the game! smile 

      Some tips: When I go to Physical Therapy they always start with a heat pad on my shoulder for 15 min prior to exercises and manipulation, followed by 15 min of ice and a stimulation (Tens). If you can do that at home before and after your exercises it may help on some of the soreness and inflammation. Purchasing a Tens Unit from my PT's office became essential for me because I was in sooo much pain; although it doesn't help the healing process at all it does help to cut through the pain cycle. You can also purchase them on Amazon I think. 

      If the pain persists when holding things (coffee cup, brushing teeth etc.) make sure you let your provider know (if you did not have that symptom before.)

      My symptoms got worse after my first cortisone shot (lost nearly all ROM in dominant arm) & 6 weeks post Hydrodilatation my pain significantly increased and the 20% ROM increase came to a halt. Now I'm at a loss on what to do. Repeat the Hydrodilatation or undergo MUA & arthroscopic capsular release. 

      Hope your FS gets better soon & wishing your husband the best as well! smile

  • Posted

    Hi all - I'm 50 from East Anglia and I've had Hydrodilatation in both shoulders in the last 12 months. The "after experience" was exactly the same in both. At first, I was terribly disappointed with the results. There was a little less pain but no more, or hardly any more movement. It didn't seem to do much.

    The answer, simply, is to wait. They'll give you some excercises to do - and yes, do them, but don't stress or worry if you don't do them all. Some will feel good and effective, some won't. Do what feels right.

    I saw the change about three to four weeks after the procedure in both cases. The pain went away and the movement came back very substantially. There was a further step change after about three months (I found), to the point were I'd say I'm pain free now and have 99% mobility back in both shoulders.

    If you have FS you know how bad it is. Hydrodilatation worked for me twice and I would 100% recommend it to anyone who is considering it.

    My only other comment is that physio doesn't work for FS. Save your time (and money if you pay for it) and see your GP about the procedure.

     

    • Posted

      I have to agree with you about physio - it has a place after hydrodilatation but not before, (in my opinion) and then only the gentle sort.  After my first procedure (for a badly frozen shoulder) the pain was pretty much gone after a couple of days, just a little discomfort if I slept too long on that side or overdid things - e.g. carrying anything too heavy.  Like you, the movement took some months to return and there were definitely step changes along the way.

      I had to argue with someone at BUPA the second time round, when he wanted me to go to physio first - but I managed to convince them and got my second procedure done at a much earlier stage.  This was the best thing I could have done and I didn't have to endure the months of torment that I had first time round.  It's about time this procedure was offered routinely for frozen shoulders.  It has minimal risks, doesn't require a general anesthetic or hospital stay and for many people, it seems to work well, in both stopping or reducing pain and regaining movement.  

    • Posted

      Hi Mark

      Thank you so much for posting your experience.  I have just had hydrodilatation on my left shoulder, and am scheduled to have the second one done next month.  So far my experience seems to follow yours, so what you say gives me so much hope.  It helps me enormously!  

      Thank you!

      Denise

    • Posted

      Hi Maria, I know you said that your hydro was done from the back with you facing down I believe and with ultrasound?  My ortho recommended hydro and I want to ask him how they do it. Did you  mean that they use the ultrasound to guide the needle?  Thanks!
    • Posted

      Yes, the ultrasound is used to guide the needle to the right place.  

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