Frozen Shoulder Treatment – Hydro Dilation (updated)

Just a quick update to say that my shoulder is now 99% back to normal and I am once more doing gardening without any pain. I am trying to be a little careful as I believe shifting heavy rocks around probably caused the frozen shoulder in the first place, but other than that I feel great. The 1% that isn’t quite back to normal is because my ‘bad’ arm is still about one inch away from touching my left ear. Somehow I’m not worried. 😀 Please read on for my post procedure experiences.

* * *

I have just had this treatment done and I thought I’d share the experience while it’s still very fresh in my mind. But first a bit of background.

The clinical description of adhesive capsulitis, or frozen shoulder to us plebs, can be found  here on wiki but I’ll give you the rather  more colourful explanation given to me by the doctor.  Apparently, inflammation or injury to the shoulder can cause spiderweb-like scar tissue to build up inside the joint. This restricts movement of the muscles and tendons attached to the joint and causes on-going inflammation which leads to even more restriction and pain. After a while even a grazing bump to the elbow on that side can cause sharp pain.

Yup, I have had all that for months but because it was my left shoulder and I’m right handed I kind of ignored it. There came a time though when I couldn’t ignore it any more because a) it was getting worse and b) I couldn’t do up a bra strap any more. Too much information? Moving on.

When I asked my GP what could have caused my frozen shoulder as I was not aware of any injury, she suggested it may have happened over a long period of time while I was happily building dry stone walls and terraces and regularly woman-handling rather large rocks. Oh. Apparently because I’m right dominant I was putting far more pressure on my left shoulder to compensate for my left arm being weaker. Oh, again.

Armed with my x-rays and ultrasound pictures I trotted off to see the specialist who cheerfully explained that for about 50% of his patients hydro dilation and follow-up exercise fixed the problem. For the other 50% an operation under general anaesthetic was required. And for some neither procedure was helpful. Oh dear.

I chose hydro dilation as the lesser of two evils and was feeling relatively confident until the specialist wrote me a prescription for Panadeine Forte and told me to take two of them about an hour before the hydro dilation. Being a clever little writer I immediately twigged that the Panadeine Forte was for pain relief. >>cue for laughter<< The specialist assured me that if I took my meds as instructed I’d be fine. Oh but I’d need someone to drive me home afterwards.

Do you have any idea how much I worried about the definition of ‘fine’ over the next week as I waited for my appointment? Not even close, sorry ; writers have such vivid imaginations….

And then today it was time to gird my loins, suck in my gut, square my shoulders… and take my meds. I made The Daughter stop off on the way in so I could buy some water to take the meds exactly one hour before the scheduled treatment. I was not taking any chances, no sirree.

Half an hour after taking the meds I began to feel rather spaced out. By the time I’d filled in forms and given my date of birth in triplicate I was feeling strangely relaxed and ready for a snooze.

The nurse tied one of those dinky hospital gowns under my left armpit and around my neck so my shoulder was exposed and then told me to lie down. The bed was positioned below some kind of x-ray device and I noticed that both the nurse and the doctor who would wield the needle had odd looking black aprons on.

To be fair both the nurse and the doctor were very nice and answered all my questions with practised kindness but the sight of those aprons kept reminding me of those old pictures of 18th? 19th? century battlefield surgeons with their sleeves rolled up and aprons covered in gore, hacking off limbs. Needleless to say I was blessing the Panadeine Forte and hoping it would live up to expectations.

The procedure itself was relatively short. First a swab to clean the skin then a pin-prick from the anaesthetic needle. Yes! Until then I thought I’d have to place all my faith in the Panadeine Forte. Such a relief to know there was more help at hand but I couldn’t help wondering why, if I was getting an anaesthetic into the shoulder, did I still need the Panadeine Forte?

The anaesthetic needle went deep and it wasn’t pleasant but honestly, it didn’t feel all that different to the needle you get at the dentist when you’re getting a root canal treatment done. The one obvious difference was that the needle stayed in so it could be used for the rest of the treatment which consisted of :

1. The injection of a steroid into the joint to stop the ‘spiderwebs’ from coming back and,

2. The injection of a liquid to force the spiderwebs  to break up.

I may be remembering things through the prism of post-treatment relief but the steroid just felt like a bit of cold pressure. The hydro dilation however felt like a lump of wood being inflated inside the joint. The moment when the spiderweb burst or broke or whatever you want to call it was painful. BUT! It wasn’t that painful and it only lasted for a moment.

I was just beginning to screw my face up in a wince when the lovely doctor said, “That’s it!”

Being quick on the up-take I said, “Is it over?”

And then that lovely, dear man in the heavy black apron smiled a beatific smile and said that yes, it was all finished.

I will still have to do lots of small, gentle exercises and see my chiropractor for a few weeks but, just between you and me, I feel better already! And no, that’s not just the Panadeine Forte speaking. The post-treatment tenderness is gone like an inconsiderate lover and already I can feel a difference.

And now for the moral of my story. Don’t let fear of the treatment put you off! I’m not saying it was something I enjoyed but it was nowhere near as bad as my hyperactive imagination had made it out to be either. Don’t laugh but I cleaned the whole house over the weekend in anticipation of being some kind of an invalid for weeks. I stocked up on cat food because I was afraid The Daughter would forget to buy enough to tide us over. I even composed a very short blog. It was going to be something like ‘I am typing one handed so will be back when I’m better’. Luckily I stopped short of composing my last Will and Testament. 😀

In hindsight I am very glad I followed instructions on the pre-meds and I would recommend them as a must-have for anyone out there also getting this procedure done. And yes, guys, I’m looking at you! Save the macho for football or cricket or something.

In conclusion I have to admit that I’m now feeling rather sheepish at being so apprehensive. The whole procedure was not that big a deal but the benefits are. I’m not doing handstands or anything silly like that but, as you can see, I am typing quite happily and feel great so if your shoulder is sore, don’t mess around. Go to your GP, get the condition diagnosed and get it fixed because the longer you wait the worse it will get and then the simpler, easier treatment options may not work. Besides, if a wimp like me can do it the rest of you have no excuses!

Courage mes amis!


p.s. I just realised this is my 100th post!

About acflory

I am the kind of person who always has to know why things are the way they are so my interests range from genetics and biology to politics and what makes people tick. For fun I play online mmorpgs, read, listen to a music, dance when I get the chance and landscape my rather large block. Work is writing. When a story I am working on is going well I'm on cloud nine. On bad days I go out and dig big holes... View all posts by acflory

91 responses to “Frozen Shoulder Treatment – Hydro Dilation (updated)

  • acflory

    Thanks, Suzie. I hope the one treatment is all you need. I’m a bit confused though, did you have the cortisone together with the saline or not? I had both at the same time and I think some of the others did too. If you didn’t, perhaps that is part of the reason you coped so well? That said, I have no idea why it would make a difference, but it’s more good information and someone else may know. 🙂


    • Anonymous

      Yes I did. Sorry for the confusion. I had cortisone on its own 2 weeks prior and I didn’t notice any improvement. So I was booked in for the hydrodilation which I believe was the same procedure as others have had with saline and cortisone.


  • Susie

    I would just like to add my experience as I had my hydrodilation 5 days ago. It might help balance things out a little as there have been some painful experiences mentioned by others and I think if I had read this before my procedure I may have chickened out!
    It was not suggested that I take painkillers prior so I didn’t. It was quite painful being put in the correct position and holding my arm there – but it is the same pain I have become accustomed to these past few months – ie the pain of stretching my shoulder further than it wants to go! They didn’t make me lie that way until a few minutes before they started so I managed. The needle itself was no more painful than any other I have had and the sting was quickly over. I felt pressure and heaviness as the saline was added. But certainly not pain – in fact by then my regular pain had lifted and I felt relieved. It was not at all unpleasant and I have actually been sleeping better since so I am feeling hopeful about my recovery.
    The Dr did say she was able to put 25ml of saline in but that I may have to return for a second one as my shoulder is very tightly frozen. I did not hear or feel any popping. I am hoping I may surprise her and be OK after just one but, if not, i would not hesitate to repeat the procedure.
    I had previously had a cortisone injection into the bursar which was bearable but definitely more painful than the hydrodilation.
    I am not doubting that others have had a bad experience but perhaps there is a difference between specialists and their expertise and experience performing the procedure – my referring Dr was quite insistent that I travel to Melbourne for mine even though I could have had it closer to home. He even specified which Drs I should have. All I can say I came out feeling on top of the world – pain free for the first time in months and not at all bothered. I found my heavy, out of control arm rather amusing and it took some hours to start getting feeling back.
    Sorry for those who have had a negative painful experience – I think we are all so fed up with pain that enough is enough. I hope it has been worthwhile for you despite the pain and that others are encouraged to know it isn’t always painful.


    • Sandy Maiol

      Wow ! how lucky you are that your hydrodylation was practically pain free . As i mentioned before in a previous post mine was excruciating . I had both shoulders done a few years apart and terrible experience both times and no one suggested pain killers to me but the dr doing it was honest and said it would be painful. I always try to be careful when doing things . Both my shoulders are still not 100 percent only have discomfort depending on how i lay in bed but don’t have the terrible pain anymore . I almost feel that my left shoulder is starting to play up again . I have found a really good chiro that helped with my back and he has helped people with frozen shoulders so l will try him before anything else if it happens again. I wouldnt mind having the name of the Melbourne dr if its ok for you to give me the name , i live in Adelaide but would travel there if i had to . Wishing you a painfree future .
      Cheers Sandy


  • Denise

    Hey your blog made me laugh out loud, as I too had the same feelings about today’s procedure….yes today I’m currently sat up in bed as I’m not tired although I haven’t slept well for weeks/months!!!
    My shoulder feels like I’ve been punched multiple times, and I still have pain on some movements! But not that excruciating can’t even breath pain, more a ouch that bloody hurts pain!!
    Hopefully in a few days I’ll be pain free and this horrific depressing debilitating condition will ease!!
    When you say to people I have a frozen shoulder people nod and think it’s just a bit of a pain, but until you’ve suffered you can not understand the level of pain one has to endure day after day!!
    Here’s looking forward to a pain free tomorrow………


    • acflory

      Hi Denise! I am sooooo glad you had it done. Once you’re feeling up to it, go to a physio or a good chiropractor to work the muscles of the shoulder as they’ve been pulled out of whack for a long time. You will get better though. I now have absolutely no pain at all, and I’m doing pretty strenuous gardening again. So great to be without pain. -hugs-


  • Sharyn

    I have a frozen left shoulder for 3 months now. After the constant pain, sleepless night and restrictive movement. The physio suggested the Hydrodilatation procedure as the ultrasound showed mild bursitis and bicep tendonitis. Although, an ultrasound may not pick up more detail compared to a MRI, the injury was not too severe but still very painful.

    Today, I had the Hydrodilatation procedure. I downed 100mg of tramadol beforehand. All the front desk staff advised that their was some discomfort and the nurses stated this too before I went in. However, I told them to cut the crap and tell me the truth. One nurse said that it is excruciating!

    They place you on the bed with the ultrasound machine sits over you. The doctor came in and positioned my arm with my palm facing upwards. He blonked a heavy bean bag on top of my palm causing me more pain as the position is very comfortable from the frozen shoulder. He inserts the needle with local antiseptic that doesn’t kick in until 30 minutes. Inserts another needle with the cortisone and then injects the saline solution which is excruciating. He tries to get 35ml but because I was in extreme pain only gets 20ml. Although, I was in agony for several minutes. I almost passed out due to the pain.

    I would never get this procedure done again and would not recommend this to anyone unless they enjoy extreme pain! I thought I had a high pain threshold as I have experienced child birth but I would rather give birth than doing this procedure ever again. Its horrendous!

    The procedure needs to be done under a general as the frozen shoulder is already painful.

    I was told by the nurse that everyone that comes in and gets this procedure done, experiences extreme pain.

    I hope the Hydrodilatation procedure is successful especially with the excruciating pain that I experienced.


    • acflory

      Ugh…I’m sorry you had such an awful experience, Sharyn. I don’t know what the pain killer was that you took but perhaps it wasn’t strong enough, or maybe you didn’t give it enough time to kick in? Mine was painful but not that bad as they managed to get all the saline in.
      I strongly suggest getting more physio or chiropractic to keep working the joint. I’m convinced that’s part of the reason I recovered full use of my shoulder.
      I hope you recover fully too. Take care.


      • Anonymous

        Thank you! I had Tramadol 100mg about an hour and a half before procedure. The clinc didnt suggest anything so I rang to see if I could take tramadol.

        They only go 20ml of salin solution before I buckled. They said it was fine. They hoped to fill the joint with 35ml.

        Because I only had half the saline solution, do you think that it won’t be as effective if I got the dosage. They couldn’t give me an answer.

        I have phsyio in a few days time and doing light exercise


        • acflory

          Honestly, I don’t know the answer. Did you feel something ‘pop’ before they stopped? That’s what happened to me BUT, I’d had my frozen shoulder for almost a year before I finally did something about it so that pop I mentioned could have been just something specific to me.
          Assuming the procedure did its job, the exercise will help your muscles adjust and /stay/ in their new positions. That’s vital to regaining full mobility, imho.
          Would love to hear how you get on. -hugs-


    • Elcee

      Awful story, Sharyn, and it matches my experience of two years ago almost exactly! The only difference is that both my technician and doctor seriously downplayed the pain I could expect (even though I told them I was very nervous.) I also felt like I would pass out, and like you, I have had 4 kids and describe myself as having a high pain tolerance!

      Later, when I spoke with the doctor by phone to talk about the terrible experience, I asked why he had directed me to fast beforehand. Was it in case they need to administer nitrous oxide gas, I wondered. No, he said, we fast people in case they vomit from the pain (!!!!!)

      Good luck with your shoulder. By the way, mine is now perfectly back to normal. Physiotherapy at the public hospital helped enormously. (Free treatment, too. Excellent service. I love physiotherapy.)


      • Anonymous

        Thank you so much for both of your support ladies.

        It certainly hasn’t been one of my most favorable days to say the least.

        Let’s hope my phsyio can work his magic.

        All the very best


      • acflory

        Ugh…the medical staff who did my procedure didn’t mention any of that,and I’m glad they didn’t. That sounds almost sadistic. 😦
        I’m glad your shoulder recovered completely though. To be honest, I’d do it all again rather than live with the constant misery of frozen shoulder.


        • Sharyn

          Thank you for your lovely words of support. Another question, did you regain full movement after the Hydrodilatation procedure was done or it did it take time with physio?


          • Elcee

            I had no improvement at all after the hydrodilatation. After about 6 months I got into the physio program and started improving straight away. It took only about 2 months of physio for me to get my range of movement back to almost 100%. SInce then it has continued improving till now I don’t notice any problem. Hope youre on the mend VERY soon!


          • acflory

            Like Elcee, I needs treatment a couple of times a week for 6? weeks but there was steady improvement week by week. I think physio or chiropractic [with massage] is vital.


  • Sandy Maiolo

    Hi Meeks
    How lucky were you that your doctor suggested Panadeine Forte , i had a frozen left shoulder that took a year and a half to get better and then the right shoulder that took two years to be 98 pe cent better. I had hydrodialation both times and had i remembered the pain i went through the first time i would not have gone back for seconds. No one suggested that i take anything before the procedure , matter of fact i asked the specialist if it would hurt and he said no ( didn’t hurt him im sure) the person who did the procedure said yes it is painful. The nurse held my arm down and the pain in my elbow and arm was excruciating . They were very nice to me and he said he can stop at any time if i had enough , i gritted my teeth and went through with it and i will say that it did help me and im almost back to normal. If it happens again i will definately look into getting the Panadein Forte.

    Cheers Sandy


    • acflory

      Thanks for sharing your experiences Sandy. I’m starting to realise just how very lucky I was with my specialist. I can’t imagine how you got through it without pain relief…and twice!
      I’m so glad both shoulders are now painfree. No one realises how debilitating it can be. I hope that all our experiences will help others who’re still struggling with a frozen shoulder.
      Take care. 🙂


  • PJ

    Hi. Shoulder specialist (Sydney) gave me a cortisone injection into the bursar in Dec 2016 with no effect. He sent me this week (March 2017) to Sydney XRAY Bondi Junction to have a just ha a ct guided cortisone injection which I had yesterday. Am considering the hydrodilatation if this cortisone does not improve things. This Sydney XRAY does the hydrodilatation. My specialist said that he would do an arthroscopic realease if not improved by late May. But I think I would try the hydrodilation first. Don’t know that the specialist I am going to would refer me for this procedure lots of the specialists are unconvinced about its effectiveness. However I do know some other Sydney shoulder specialists do send people with frozen shoulder for the hydrodilatation treatment. I may have to switch specialists.


    • acflory

      Hi PJ. The specialist I saw here in Melbourne uses hydrodilation where applicable, but he did warn me that it might not work. I’m not sure whether having the cortisone and hydrodilation at the same made a difference, but something worked for me. Keep searching because your specialist may just be…old school. 😦
      Good luck and I really hope you find relief soon. Frozen shoulder is the pits.


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