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

    Please update us, my ortho is recommending the same thing for me, hydrodialation with PT.  Unsure.

     

  • Posted

    Hi, thank you so much for information on your journey. My question to this group - PLEASE HELP!!

    >> Q: Has anyone had Hydrodilatation done in the Florida panhandle area USA? <<

    My wife has a frozen shoulder and needs this treatment. We now live in Florida USA.

    My History:

    I suffered a frozen shoulder back in 2005 in Melbourne, Victoria, Australia. It was painful and debilitating and affected my work and social life. I was in my early to mid-thirties at the time. After 3 months it became clear it wasn't getting better. After 3 months of physiotherapy, my trusted physio indicated he couldn't help me. We had established that my right shoulder joint was quite worn out from years of carrying a heavy schoolbag incorrectly (just on one shoulder), and subsequent 15 years of carrying a laptop bag on one shoulder as well.  After a GP Doctor visit I saw a specialist, who tried a steroid injection that was unhelpful. I was recommended by the GP to undergo Hydrodilatation. I had the procedure done firstly by a local specialist - with exercises to follow up with. My recollection is that it provided a little pain relief, but no mobility improvement. The pain relief was gone after a few weeks and it was just as bad. I then got a reference to a specialist in Melbourne who was reputed to be the best in Australia - evidenced by him being the practitioner of choice for professional Australian Football players. I waited 3 months to be seen. He suggested re-tying the Hydrodilatation as (in his words) "there is a bit of an art to it".  The procedure provided immediate and significant relief. Cautious follow up physio resulted in a return of mobility to about 90%. It is not perfect though. Since the treatment I have learnt that my shoulder cannot bear significant workloads that involve raising my arms up higher than neck height for very long. During (and after the frozen shoulder) I started using a "trundle" style briefcase that I pulled along with wheels so I didn't have to bear the weight. I always use a backpack on 2 shoulders now. 

    Now my wife is suffering this condition, and I am trying to find a clinic or hospital to do this for her.

  • Posted

    Thank you for this. I’ve just joined this forum after being diagnosed with frozen shoulder last week following  6 months of pain ( and different diagnoses!). I’m down as urgent to have  hydrodilatation and am hoping it will be in the next few weeks. The pain is awful and lack of sleep doesn’t help. I’ve just been signed off sick too as I can’t drive so money is another worry! I really hope it works for you and you’ve put my mind at ease regarding the procedure itself so thank you! 
    • Posted

      I've just had my second hydrodilation done.  First time it worked perfectly for 3 months then came back with a vengeance.  I was very early in the disease process.  Now I am fully in the frozen phase, which doc says is the best time to get it done.  It hurt MUCH worse than the first time, and they could only get 20mls in, not 40.  Here's hoping it lasts this time!

    • Posted

      Thank you Sarah. I really hope it helps you permanently this time! Let me know how it goes. I’m still waiting for my appointment. Fingers crossed it won’t be much longer, it’s getting me down! 
  • Posted

    Thanks for this - very interesting. I've been to first physio session today & hydrodilation was suggested as a possible option for me. So I will follow your story with interest.

    My other shoulder was frozen years ago & successfully treated with a steroid injection by my GP and has been fine ever since, but this time its my dominant arm so more debilitating.

  • Edited

    hi, Ive just found this thread. I have 2 frozen shoulders, started a couple months apart from dislocation and bursitis. I was wondering how you are now? my orthopedist has offered hydrodialation to me and im a little hesitant since i had an ultrasound guided cortisone shot that caused a massive cortisone flare and took a month to recover from. I've been doing acupuncture and PT and thats been helping. Its been 6 months now for me and my life is completely on hold

    • Posted

      Hydrodilatation worked very well for me, both times, where physiotherapy did not. It certainly got rid of the pain and shortened recovery time. I'm not sure what causes cortisone flares or whether having had one before, it means you will get one next time. I suppose it is a risk that you'd need to discuss with the specialist. Good luck, whatever you decide.

    • Edited

      hi, unfortunately my experience of hydrodilatation was a very negative one. the pain was unbearable and he could only get 25ml in. I can't say truthfully if it helped. It was still painful for some time and remains frozen although 5 months after the procedure its not as painful at all, just restricted movement. saying that, I know its not been a painful experience for many others so may work for you. Good luck and I hope it eases soon.

    • Posted

      I had a horrible flare from a straight cortisone injection for bursitis which was evil, but the amount of cortisone they use in hydrodilatation is minimal and not equivalent.the main concept if hydrodilatation is that of stretching and posibly rupturing the over thickened tissue which surrounds the capsule of the joint.it doesn't rely on cortisone as a main part of the treatment. if it's truly bad I'd give it a go. frozen shoulder lasts much.longer than a cortisone elated and us far more debilitating anyway and I suspect you would be unlikely to have one. discuss this with your radiologist.

  • Posted

    hi, hydrodilation cured my 2nd frozen shoulder (took 2 rounds 3 months apart), but was extremely painful. i think the key to it working is getting it done very early on. cortisone is still needed for hydrodilation though, so if you are prone to cortisone flare i would say not worth it. overall the hydrodilation shaved about a year off my recovery time. ive had fs in both shoulders so i know.

    • Posted

      thank you for that . you said it was very painful - after the procedure it was painful? or just getting the procedure done ?

  • Edited

    hi had this procedure done on valentines day 2020 was given local anaesthetic, literally under a minute later the surgeon started to put the big long needle into my muscle and down to the bone, i have never felt pain like it in my life it was explosive pain when he started to push it down i felt everything , once he was down to the bone he put the steroid in and it felt like my arm was going to pop then all of a sudden no pain... im thinking this is when the anaesthetic kicked in but he had already done the whole procedure! i nearly fainted with the pain! is this normal? i was so upset i was shaking uncontrollably. its absolutely traumatised me.

    • Posted

      Sorry to hear you had such a painful experience - it was certainly not my experience and I've had the procedure twice, once in each shoulder (at different times). The first was a very badly frozen and painful shoulder, the second I knew the signs and went earlier to pre-empt it getting any worse. I felt a bit of discomfort and a pushing sensation - but not really painful at all - it should be going into the joint, not to the bone.I think maybe it depends on the skill of the person doing it and also which way they do it.

      My treatment was done guided by ultrasound and the needle went in via the back of the shoulder joint. I asked the radiologist why some people find it painful and he said that (apart from simply difference in people) some do the procedure by putting the needle in to the front of the shoulder - especially when guided by xray - and this can be more painful. He said that they (that hospital clinic) stopped doing that some time ago.

      I hope after all that, the hydrodilatation works for you and you get relief from this awful condition. I hope others aren't put off by your experience - it is not necessarily a painful procedure and worked wonders for me both times.

    • Edited

      Hi there, I totally had the same experience.

      I had the procedure back in 2017 and will never forget. I almost passed out as I stopped breathing and heard the nurse yelling "Breathe ". I remember my good arm automatically trying to claw at the radiographer who was doing the procedure.

      I was so traumatized as I have never felt anything like that. I couldn't believe how painful it was and complained to management.

      Never again...

    • Posted

      Hi Linzio, i have just had my second experience with a hydrodilitation and wow the pain was excruciating, so much so they didn't even try putting solution in (they managed to get the steriod in and nothing else). It was done by Frank Burke in Melbourne (he apparently brought the proceedure to Australia). I was told I would have to come back again in a few weeks and it wouldn't hurt as much second time around. Needless to say I doubt I can go through that again as I too feel traumatised by the experience. I am however, experiencing significant pain relief that Tramadol, Lyrica etc did nothing to touch (I'm day 6 post proceedure). In contrast my first frozen shoulder in my left arm, 3 years ago didn't respond so badly to the hydodilitation proceedure. It was very uncomfortable but ultimately bearable and I did feel a popping sensation with the amount of fluid they managed to get in (pain relief only lasted 2 weeks and the pain came back with a vengence). Both my FS have been diagnosed on the severe end of the spectrum and neither resulted from an injury. I am (desperately) hoping I get better results re pain relief this time around and to be honest movement is the least of my worries compared to the pain. How have things worked out for you? It would seem your experience is close to my own so I was wondering how you are getting on and if you have any recommendations? From all the research I have done and the MANY different therapists I have been to for help, FS recovery/treatment is an art form and not a science and one persons experience can be completely different to another's! It's great to read a forum where all the different experiences are shared because some (most) days I feel like a moaning middle aged woman who just needs to toughen up. Then the pain takes over and toughening up is impossible...

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