Paincare Florida

Hydrodilatation

Pain Treatment Procedure

Hydrodilatation (Joint Distention)

Frozen shoulder (also known as adhesive capsulitis) is a painful and limiting condition that affects the joint capsule—the soft tissue and ligaments surrounding your shoulder joint. As the capsule thickens and tightens, it restricts movement and makes using your shoulder harder (and more painful).[1] Unfortunately, the less you move it, the worse it can get.

Hydrodilatation, also known as joint distension, is a targeted procedure that gently stretches the joint by injecting a mixture of saline, corticosteroids, and local anesthetics. This helps relieve pain, loosen the tight tissue, and improve your range of motion.

How Shoulder Distention Works

Hydrodilatation, also known as capsular distension, works by gently stretching the joint capsule—the connective tissue that surrounds the joint—using a pre-measured injection of sterile fluid. A mix of saline, corticosteroid, and local anesthetic is injected into the joint under imaging guidance, typically using ultrasound or fluoroscopy.[2] This helps relieve stiffness by expanding the tight, thickened capsule that’s causing limited movement and pain.[3,4]

By stretching the joint, hydrodistention helps to break up adhesions (scar-like tissue) and restore normal movement. The corticosteroid also helps reduce inflammation, providing additional pain relief.[5]

Conditions Treated with Hydrodilatation (Capsular Distension)

Arthrographic distension (hydrodilatation) is most commonly used to treat:

Frozen shoulder (adhesive capsulitis) is a condition where the shoulder joint becomes stiff, painful, and difficult to move due to thickening and tightening of the joint capsule.[1] Common in women over 40 and diabetic patients.[1]

It may also be used to break up scar tissue and restore mobility for:

  • Post-surgical shoulder stiffness [6]
  • Post-traumatic joint stiffness [7]
  • Hip joint adhesions [8]
  • Ankle joint stiffness [9]

Patients with frozen shoulder often report significant improvements in range of motion and pain reduction following the procedure.[10, 11]

Benefits of High Volume Hydrodilatation Injections

Chinese medicine refers to frozen shoulder as ’50-year-old shoulder syndrome’, but hydrodistension injections can help stretch and loosen up the shoulder capsule (joint), delivering relief and better mobility.

Here are several benefits of hydrodilatation:

  • Quick Recovery Time: Resume light activity the same day
  • Hyper-Targeted Treatment: Reduces pain and inflammation within the affected joint space.
  • ​Improves Joint Mobility: Gently stretches the joint capsule, restoring use of the shoulder/arm.
  • Minimally Invasive: No large incisions or damage to connective tissues or muscle.[12]
  • Low-Risk Surgical Alternative: Ideal for patients seeking to avoid shoulder replacement surgery while restoring range of motion safely. [12]
  • Enhances Treatment Results: Relieves pain and improves range of motion, helping you regain normal function faster, especially when combined with physical therapy.[2]

Consult a Hydrodilatation Specialist for Pain Management

Hydrodilatation may be a great option if you:

  • Have a frozen shoulder that hasn’t improved with self-care or standard treatments
  • You are recovering from shoulder surgery or an injury and struggling with stiffness
  • Want a minimally invasive solution instead of surgery
  • Feel limited by pain and restricted movement—whether in sports, work, or everyday life
  • Can’t sleep or perform daily tasks due to shoulder pain
  • Are in the early stages of frozen shoulder and want to prevent worsening stiffness

A holistic approach to pain care means not just treating symptoms but also considering the broader picture, encompassing movement, healing, and overall quality of life. Whether you’re managing a chronic condition or recovering from an injury, maximize your results with a personalized treatment plan from a reputable pain management clinic.

Ready to enjoy pain-free movement? If joint stiffness limits your life, hydrodilatation could help you move freely again. Schedule your pain management consultation to determine if this safe and effective treatment is right for you.

Resources:

  1. Frozen Shoulder (Adhesive Capsulitis). Cleveland Clinic [Internet]. Accessed May 29, 2025. Available from: https://my.clevelandclinic.org/health/diseases/frozen-shoulder-adhesive-capsulitis
  2. Shoulder Hydrodilatation for Frozen Shoulder. Gateshead Health [Internet]. Published February 7, 2024. Accessed May 29, 2025. Available from: https://www.gatesheadhealth.nhs.uk/resources/shoulder-hydrodilatation-for-frozen-shoulder/
  3. Cho JH. Updates on the treatment of adhesive capsulitis with hydraulic distension. Yeungnam Univ J Med [Internet]. 2021;38(1):19-26. doi:10.12701/yujm.2020.00535. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7787893/
  4. Murphy A, Knipe H. Glenohumeral joint hydrodilatation. Radiopaedia [Internet]. Published online November 18, 2014. doi:https://doi.org/10.53347/rid-32213. Accessed May 29, 2025. Available from: https://radiopaedia.org/articles/glenohumeraljoint-hydrodilatation?lang=us
  5. Haughton DN, Barton S, Meenan E, et al. Can we improve the outcome of hydrodilatation for adhesive capsulitis?. Shoulder Elbow [Internet]. 2018;10(2):93-98. doi:10.1177/1758573217706199. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5851122/
  6. Lädermann A, Piotton S, Abrassart S, Mazzolari A, Ibrahim M, Stirling P. Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc [Internet]. 2021 Aug;29(8):2553-2563. doi: 10.1007/s00167-020-06390-x. Epub 2021 Jan 9. PMID: 33420809. Accessed May 29, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/33420809/
  7. Makki D, Al-Yaseen M, Almari F, et al. Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis. Shoulder & Elbow. 2020;13(6):649-655. doi:10.1177/1758573220977179. Accessed May 29, 2025. Accessed May 29, 2025. Available from: https://journals.sagepub.com/doi/abs/10.1177/1758573220977179
  8. Yoon B, Jae Chan Shim, Lee M, Hyoung Keun Oh, Sung YB, Suk Kyu Choo. Ultrasound-guided hydrodilatation for adhesive capsulitis of the hip is a safe and effective treatment. International Orthopaedics [Internet]. 2021;45(6):1455-1461. doi:https://doi.org/10.1007/s00264-020-04909-y. Accessed May 29, 2025. Available from: https://link.springer.com/article/10.1007/s00264-020-04909-y
  9. Touhey DC, Beady ND, Tartibi S, et al. Medial Malleolar Stress Fracture Treatment and Return to Activity: A Systematic Review. Foot & Ankle Orthopaedics [Internet]. 2024;9(4). doi:https://doi.org/10.1177/2473011424130346. Accessed May 29, 2025. Available from: https://journals.sagepub.com/doi/10.1177/24730114241303463
  10. Pimenta M, Vassalou EE, Klontzas ME, Dimitri-Pinheiro S, Ramos I, Karantanas AH. Ultrasound-guided hydrodilatation for adhesive capsulitis: capsule-preserving versus capsule-rupturing technique. Skeletal Radiol [Internet]. 2024;53(2):253-261. doi:10.1007/s00256-023-04392-7. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10730627/
  11. Frozen Shoulder. Johns Hopkins Medicine [Internet]. Published March 21, 2023. Accessed May 29, 2025. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder#
  12. Poku D, Hassan R, Migliorini F, Maffulli N. Efficacy of hydrodilatation in frozen shoulder: a systematic review and meta-analysis. Br Med Bull [Internet]. 2023;147(1):121-147. doi:10.1093/bmb/ldad018. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10788845/
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