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iPS provide Hydrodilatation Injections in Cardiff, Carmarthen, Bridgend, Newport and Porthcawl Frozen shoulder, also known as Adhesive Capsulitis. Our Hydrodilatation Injections are adminstered by qualified and experienced physiotherapists and are ultrasound guided to improve the precision and effectiveness of the treatment.
*Please book an Initial Consultation if you wish to book an injection. A consultation fee is paid at the time of booking. Injections will only be administered if clinically approriate. Following the assessment, you will be required to pay the cost of any injection(s) administered during the appointment. More than one injection may be required following the assessment. If you require more than one injection during your appointment, additional injection(s) will cost £180 per injection.
Hydrodilatation also known as Hydrodistention and High-Volume Shoulder Injection is a highly effective treatment for Frozen shoulder, also known as Adhesive Capsulitis. Hydrodilatation is increasingly used as the first-line treatment of a frozen shoulder and is recommended by the National Institute of Clinical Excellence (NICE). The injection often provides significant relief of pain and speeds up restoration of shoulder range of movement.
Hydrodilatation involves the injection into the shoulder joint capsule. This procedure must be performed under ultrasound guidance to ensure accurate needle placement inside the shoulder joint capsule. A relatively large volume of saline (20-30ml) and small amount of local anaesthetic and steroid (cortisone) is injected into the joint, with the aim of deliberately stretching the tight capsule and reducing the inflammation.
Our specialist physiotherapist Gareth Tremain completed a Masters degree module in 'Joint & Soft Tissue Injections' at Keele University in 2013 and has undertaken extensive training with specialist doctors, sonographers and consultant physiotherapists to hone his skills in Ultrasound-Guided Injections. He offers a range of Ultrasound-Guided Injections, including Cortisone, Hyaluronic Acid, High Volume and Hydrodilatation to treat a wide range of persistent injuries and chronic pain. Gareth will also advise you regarding the most appropriate exercise programme to complement your injection.
Hydrodilatation involves the injection of a sterile solution (usually a mix of saline and corticosteroids) into the shoulder joint. The pressure from the injected fluid helps to stretch the capsule surrounding the shoulder joint, breaking up any scar tissue that may have formed. This procedure is typically performed under imaging guidance, such as ultrasound or fluoroscopy, to ensure accurate placement of the needle. The injection helps to reduce inflammation, increase joint space, and improve the range of motion in the shoulder.
The injection may cause mild discomfort during the procedure, but local anaesthesia is used to numb the area and minimize pain. Most patients find the procedure tolerable.
Many patients experience relief from pain and stiffness within a few days after the injection. However, the full benefits may take a few weeks to develop as the joint heals and inflammation decreases.
Typically, one Hydrodilatation Injection is sufficient for most patients. However, additional injections or follow-up treatments may be recommended depending on your condition and progress. Your physiotherapist will work with you to develop a treatment plan that is best suited for your recovery.
A Frozen Shoulder can cause severe shoulder pain and debilitating restriction of movement. It is caused by inflammation and tightening of the shoulder joint capsule. It is most common in middle-aged female patients. It often occurs following trauma to the shoulder, but it can come on for no obvious reason (which is termed idiopathic). Certain medical conditions such as diabetes and hypo/hyperthyroidism have been shown to increase risks of developing a frozen shoulder and may also cause the condition to be more resistant to treatment. If untreated, a frozen shoulder will gradually resolve in most people. However, it often takes 18-24 months to fully resolve.
A frozen shoulder will usually start with severe pain, which then develops into pain and stiffness, resulting in a marked loss of range of motion around the shoulder. Patients find real difficulties with activities such as washing their hair, reaching for a seatbelt and putting on a coat.
Other shoulder conditions, such as shoulder arthritis can present with similar symptoms and physical restrictions, so it is important that the patient is fully assessed by an experienced clinician before deciding to proceed with this treatment. We prefer patients to have an x-ray before proceeding with a hydrodilatation injection, to help confirm the shoulder is otherwise healthy.
Most people only need one injection to help them achieve satisfactory pain relief and help them gradually improve their shoulder range of movement. However, it is possible to repeat the procedure if you feel it is necessary. We recommend a minimum of 3 weeks between injections and recommend no more than 3 injections into your shoulder in one year.
Traditional treatments such as stretching exercises, (without first having an injection) can be very painful and often provide little benefit.
There is still some uncertainty regarding which injection provides the best result. Injecting a small dose of cortisone into and around the shoulder joint (Ultrasound-Guided Cortisone Injection) also provides very good results if undertaken during the early stages of a frozen shoulder, but it seems as if hydrodilatation may produce slightly better results. Research has shown that undertaking a graded stretching programme following either of these injections leads to a faster return of joint range of movement. Our specialist physiotherapist will advise you regarding an appropriate exercises.
Even though research shows that hydrodilatation or a cortisone injection will speed up the recovery in the majority of patients, it is important to understand that it is not a guaranteed cure. Our specialist will advise you on the alternative options, if this does not work for you.
Hydrodilatation has been shown to be as effective in improving range of movement as a Manipulation Under Anaesthetic - MUA (forcefully stretching shoulder joint capsule whilst the patient is unconscious under general anaesthetic). Patient satisfaction levels have been shown to be significantly higher following hydrodilatation compared to an MUA. If none of the above treatment resolve the pain and stiffness associated with a frozen shoulder, the last resort would be a surgical procedure - generally this involves an arthroscopic surgical release. This is essentially keyhole surgery, whereby the surgeon makes small incisions in the joint capsule to attempt to improve the range of movement and pain.
We want to ensure that all of our patients receive the information they need to make an informed decision about their treatment. If you have any questions or if you require assistance with anything, please let us know.
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