“Frozen Shoulder”, medically known as adhesive capsulitis, can be a frustrating and painful condition. Characterised by stiffness and limited movement in the shoulder joint, it can last for months, or even years. While it may be triggered by trauma, inflammation, autoimmune issues (like arthritis), or prolonged immobility, many cases have no clear cause at all.
Steroid Injections vs Hydrodistension: What’s the Difference?
Two common treatment approaches are steroid injections and hydrodistension (also called hydrodilatation). Both aim to reduce pain and improve movement, but hydrodistension offers several advantages that make it a more comprehensive and effective option for many patients.
- Steroid Injections: Steroid injections, especially when ultrasound-guided, have long been a go-to option. They’re quick, relatively low-cost, and often bring fast relief. However, their benefits may be short-lived and primarily anti-inflammatory.
- Hydrodistension: Hydrodistension involves injecting a large volume of sterile saline, local anaesthetic, and cortisone into the shoulder joint under ultrasound or X-ray guidance. The goal is to stretch the tight capsule, break down internal adhesions, and improve movement – sometimes producing an audible “pop” as the capsule releases.
Why Hydrodistension may be the better choice
- Better Range of Motion: Physically expands the joint capsule, often with greater mobility gains than steroid alone.
- Longer-Lasting Relief: Studies suggest benefits can last longer than traditional steroid injections.
- Diagnostic Value: Confirms tight capsule and restriction during the procedure itself.
- Addresses Root Cause: Helps break up scar tissue and adhesions that contribute to the frozen state.
- Stimulates Healing: Mechanical stretching may encourage natural repair and tissue remodelling.
What to expect after the procedure
Some mild discomfort may occur for up to 30 minutes after the procedure. Temporary bruising around the injection site, numbness of the skin, or a sensation of fullness or tightness in the shoulder are all common and generally resolve within 48 hours. Over-the-counter pain relief can be taken if needed.
Most individuals can resume normal daily activities within 24 hours, including returning to work. However, it’s recommended to avoid driving or operating heavy machinery for the rest of the day due to temporary numbness or discomfort.
To maximise the results of hydrodistension, restarting physiotherapy within two to three days is advised. Early mobilisation helps to maintain the newly gained range of motion, prevents the joint from stiffening again, and supports long-term recovery.
When to consider Hydrodistension
Hydrodistension is particularly useful for those who’ve had limited success with steroid injections alone and may even be an alternative to more invasive procedures like manipulation under anaesthesia (MUA). It’s safe, effective, and may help patients avoid surgery altogether.
By addressing both inflammation and joint restriction, it targets the root cause rather than just managing symptoms. Many patients report significant improvement in mobility and function within days, making it a valuable option for those seeking a faster, less invasive route to recovery. When combined with a structured rehabilitation programme, hydrodistension can lead to long-term relief and restored shoulder function.
Private Injection Clinics offer both hydrodistension and steroid injections for the treatment of frozen shoulder. For more information please take a look at our website.
Private Injection Clinics are based on the coast in Leigh on Sea and in Colchester, Essex – perfect for patients in Essex, Kent, London, and surrounding areas.
Resources
- https://www.privateinjectionclinics.co.uk/treatments/hydrodistension/
- https://www.privateinjectionclinics.co.uk/treatments/steroid-injections/
- https://www.nhs.uk/conditions/frozen-shoulder
- https://www.kch.nhs.uk/wp-content/uploads/2023/01/pl-940.1-frozen-shoulder-adhesive-capsulitis.pdf
- https://sonoscope.co.uk/blog/can-steroid-injections-help-with-frozen-shoulder/
- https://www.topdoctors.co.uk/medical-articles/hydrodistension-injection-for-frozen-shoulder