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!
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.
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."
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.
Can I ask you where you had it done?
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.
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.
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!
Hi from Australia,
I have been suffering for 6 mnths with this. Wow, I thought I was going to go mad. In dsigust at my GP telling me that I was letting it get to me, (no soid sleep for 6 mths nd not missing a day of work might I add) I changed GPs. I went to see a new one on Monday who ordered a CT scan of my neck. I have had an MRI of my shoulder and it showed a spur, bursitis, a small tear in my shoulder and frozen shoulder. He thinks that the intense pain is due to something going on in the neck. He has also recommended the treatment that you are discussing. Likewise, I feel I am desperate enough for nything right now. It will be the first CHristmas that I simply am to tired to bother with although with 2 small grandchildren I shall make an effort.
How can something like this affect so much of your life? How can they look at you with an expression that almost says "another middle aged hormonal woman moaning about a sore shoulder"
Perhaps I am simply over sensitive!
Anyway - this wonderful new GP prescribed me Tramadol - one at night. I took it reluctantly last night and whoo hoo I had 3 hours of continuous sleep! Small steps forward finally!
Wishing you well. Keep us posted!
Hi Claire, sorry to hear you are in so much pain. Unfortunately, apart from the lack of movement, we don't look ill with a frozen shoulder. It's no excuse for the behaviour of some GPs. As for hormonal - I am convinced there is a link between a drop in hormones and the onset of frozen shoulders in women - there are too many anecdotal cases - it's surely worth some research.
My treatrment hasn't miraculously improved my shoulder movement (it does for some) - though I do think it's a bit better. I suspect for me that slow and steady progress is more likely. It has however left me largely pain-free, which for me is my main priority.
Hope you get treatment that gives you some pain relief soon - we all know how painful it is and how desperate it makes you feel. I'll also be spending my Christmas Day with 2 grandchildren (aged 3 and 10) so know how much that means to you. Hope they help keep your mind off the shoulder, at least for a while. Best wishes for a peaceful Christmas and hope you start to feel much better soon. Take heart in knowing it WILL get better!
Well I am glad the pill gave you some relief but aren't they going to do something to treat your condition like surgery?? I had one surgery here in the States that fixed my tear and frozen shoulder and am fine now 9 weeks out. What use is a pill that relieves pain for 3 hours but does not solve the problem???
Hi Maria and Lambchop2
Yes I had a great Christmas day with both little ones taking my mind off the pain for a while. I intend to get something done. I am a teacher and need to work. I feel I have 6 weeks to make a start on some treatment. The thing is, it is aslow process here and although I am willing to pay to go private, the waiting lists are extraordinary, nothing seems to be a priority either....
Like you Maria, I am certain the drop in hormones is linked to it. In my opinion, there is not enough research being made into this condition, whic, while not urgent or life threatening, is most debilitating.
Claire
I hope everyone managed to have a good Christmas, despite their shoulders! I just wanted to let you know of something that would seem very minor to most - but felt like a big step forward to me.
I have long hair and in recent years, have taken to wearing it up, twisted round and held in place by one of those hinged claw clips. My freezing shoulder made this increasingly difficult and I remember the exact day in September when, however hard I tried, I could no longer do this. I remember crying with sheer frustration.
Over Christmas I noticed that it was getting a little easier to wash my hair with 2 hands. I decided at first to try to plait my hair at the back - again, something I haven't been able to do for some time. With a little difficulty I managed it. Then I tried the clip - again, not exactly easy but I got it in place and felt elated. OK, to most this seems very trivial - but to me it's a small victory and gives me hope for better things in the New Year. At last, there looks to be some light at the end of this dark frozen tunnel.
Good luck to all of you and lets hope the New Year brings us all some relief from this awful condition!
I know what you mean. I had shoulder surgery three months ago and am just beginning to feel the benefits. Having a shower and washing my hair ten days post surgery after having the stitches out. Being able to brush my teeth, the my hair back at last to drive a short distance. Mean souh to me too as I am single mother living in a remote Wiltshire village. The most challenging for me has been having to stay at home feeling very disconnected and totally relying on other people. I have always been highly independent
Such good news to read this, after almost seven months of struggling I see mynew GP tomorrow. (I changed as the previous GP told me I was letting it get to me as it was only a frozen shoulder) I am over not being able to put my bra on, comb my hair properly, hang out the washing properly, air the bed by fluffing up the king size duvet, reach up to get something off the top shelf etc. The list is endless. Most of all I am seriously over not being able to sleep without pain. The stronger pain killers no longer work and I am up pacing the boards most nights.
I feel guilty moaning about it, I am sick of listening to myself. My nextdoor neighbour has terminal cancer, how could I even think of moaning about my shoulder, alas I do though..................
As my husband reminds me, with a serious disease, injury, broken limb etc. people recognise it and are prescribed painkillers. With a FS, I have had to fight for an xray, analgesics, ultrasound and 2 MRIs.
Ridiculous really!
I thought I'd add an update to this. as the subject has come up on other threads and Friday was the date for my follow-up consultation. It's almost 7 weeks now since I had my hydrodilatation. I'm still pain free and life is pretty much back to normal for me. I am without pain and can sleep without being propped up on cushions,, though it still feels a little uncomfortable to sleep on my frozen side. I'm doing my excercises, as and when I think about them - gentle stretching and strengthening excecise (done at home). At the extemeties of my stretch, I feel some discomfort (that's where I stop) but have no residual aching afterwards.
Slowly but surely, my movements are improving. Putting up my hair gets easier every day and a couple of weeks ago I realised I could fasten my bra, without sliding it round the front. It's still a little awkward but getting easier all the time - such little things can feel like a major achievement! I've found the best way of excercising for movements behind your back is in the shower - sliding the bad arm up with the help of the other one when soapy makes it much easier. I can't get my arm right up yet but it isn't causing me any major issues, so as long as I'm without pain, I'm happy continue exercising and getting the movement back slowly.
I'm still unsure whether my other shoulder is starting to freeze. Some days I have a slight ache and tight feeling at the top of that arm and into my shoulder - but other days it is OK. I'm hoping it will be OK but if not, will seek help a lot earlier than I did with my right shoulder.
My consultant was happy with my progress and said the movement should continue to improve in time. He said to go directly back to him, should I have any further issues or pain or if my other shoulder does freeze. I'd have no hesitation going for an earlier hydrodilatation, should that happen. I'll report back, if there are any dramatic changes - either good or bad.
Good luck to all of you going through this awful condition and I hope you too can find some releif!
Just wondering what makes people choose hydro dilation over anthroscopic keyhole surgery. My whole arm aches forearm fingers feel like I can't cope with life anymore, plus have a rotator cuff tear tendinitis burs titis in opposite arm.
I think it is a little gentler? Less invasive?
As Claire says, it is less invasive and very safe. It's done by an injection - no surgery, keyhole or otherwise, so no general anaesthetic or recovery time. Done in about 15 minutes at an out-patients clinic. My consultant claims very good results for it at his clinic with 90% getting improvement in pain relief and 70% in movement. You'd need to ask a consultant about whether it is suitable, if other conditions exist but for a frozen shoulder it is well worth trying, if it is available where you are.
I've just read your threads with interest. My physio has now recommended that my doctor refers me to the local shoulder clinic to see a consultant about having a Hydrodilatation. I have had my frozen shoulder since about July 2015. I didn't go to the doctors until November and he referred me to the Physio. After a couple of sessions I was given a cortisone injection the week before Christmas, which worked wonders. following Christmas I was admitted to hospital due to developing an infected carrabuncal in my stomach, caused by my insulin pump cannula. This was removed, and left a large gapping wound which is having to be packed and dressed every other day. This has caused me some problems as it on the opposite side to my FS and I am now unable to sleep on this side now. The injection has warn off now and the pain is back and feels 100% worse than before. The physio informed me I have less movement now than when I first went to her. I am willing to try anything now. It hasn't affected me going to work and I haven't taken time off for this. I just keep popping the pills and hope that they take the edge off the pain. I've been told it will take approximately two weeks to get my appointment with the consultant and then approximately 4 weeks to get the appointment date for the procedure. It's going to feel like the longest time. I am at the doctors tomorrow to discuss the referral, but also yo get some stronger painkillers, can anybody recommend painkillers, other than paracetamol and codeine please. I will keep you update with my progress.