The short answer
Frozen shoulder (adhesive capsulitis) causes pain and stiffness as the joint capsule thickens. Hydrodilatation — an ultrasound-guided injection of saline, lidocaine, and steroid — expands the capsule and can provide immediate relief, especially when combined with physical therapy.
Written by Marc Gruner, DO, MBA, RMSK
Sports medicine physician, Mayo Clinic fellowship
Treating Frozen Shoulder with Capsular Distension — Dr. Marc Gruner
Frozen shoulder, or adhesive capsulitis, is characterized by pain, stiffness and loss of range of motion in the shoulder joint. The joint capsule becomes tight and inflamed.
Physical therapy is the cornerstone treatment for frozen shoulder. During physical therapy, the arm and shoulder are stretched to the point of tension, but not pain. This expands the joint tissues, slowly improving pain and range of motion over time.
Hydrodilatation, or joint capsule distention, is an extremely effective treatment when used in conjunction with physical therapy. First, the front of the shoulder is numbed with lidocaine. Then, using ultrasound guidance, the joint capsule is injected with a mixture of saline, lidocaine and steroids. The volume of the injection works to expand the joint capsule and break up adhesions. Lidocaine and steroids provide immediate pain relief and reduce inflammation.
Immediately following the procedure, patients will experience pain relief and increased range of motion. Continuing physical therapy as part of an integrated medicine approach will improve the symptoms even further.
Frequently asked questions
- Is hydrodilatation painful?
- The injection is performed under ultrasound guidance with local anesthetic in the mixture; most patients tolerate it well and feel relief quickly.
This article is for general education and is not a substitute for individualized medical advice. Please consult a qualified clinician about your specific condition.