Effective treatment for frozen shoulder: ultrasound-guided hydrodilatation explained
What is Frozen Shoulder?
Frozen shoulder, or adhesive capsulitis, is a condition that causes significant pain and restricts movement in the shoulder joint, affecting daily activities and quality of life. One effective treatment option is shoulder hydrodilatation, a minimally invasive procedure involving a saline injection to stretch the joint capsule, reduce pain, and improve mobility. Ultrasound guidance ensures precision in the injection, enhancing treatment efficacy.
Understanding Adhesive Capsulitis
Adhesive capsulitis, commonly known as frozen shoulder, progresses through three stages:
Freezing Stage: Gradual increase in pain and restricted movement lasting six weeks to nine months.
Frozen Stage: Reduced pain but persistent stiffness lasting four to six months.
Thawing Stage: Gradual improvement in movement and decrease in pain over six months to two years.
Risk factors include diabetes, thyroid disorders, and shoulder injuries or surgeries. Adhesive capsulitis can severely impact daily activities like dressing and reaching for objects.
What is Ultrasound-Guided Hydrodilatation?
Ultrasound-guided hydrodilatation is a minimally invasive procedure to treat persistent shoulder stiffness and pain. It involves injecting a saline solution, often mixed with a corticosteroid, into the shoulder joint to stretch the capsule, relieve pain, and improve mobility.
Procedure Steps:
Ultrasound Guidance: Visualizes the shoulder joint for precise needle placement.
Injection Process: A local anesthetic numbs the area, followed by the saline-corticosteroid injection, stretching the capsule and breaking down adhesions.
Immediate Effect: Pain relief from the anesthetic, reduced inflammation from the corticosteroid, and improved mobility from the capsule stretching.
Comparison with Other Treatments
Physical Therapy: Often the first treatment but can be slow. Hydrodilatation offers faster improvements.
Corticosteroid Injections Alone: Reduce inflammation but do not address the tight capsule. Hydrodilatation combines anti-inflammatory benefits with mechanical stretching.
Surgery: Considered for severe cases but hydrodilatation is less invasive with a shorter recovery time.
Indications and Ideal Candidates
Hydrodilatation is suitable for patients with persistent shoulder pain and restricted movement lasting over three months despite conservative treatments. It is ideal for those preferring a non-surgical approach and individuals with underlying conditions like diabetes or thyroid disorders.
Contraindications:
Active infection in the shoulder joint.
Allergies to corticosteroids or anesthetics.
Advanced osteoarthritis in the shoulder.
Procedure Details
Pre-Procedure:
Medical evaluation and imaging studies confirm the diagnosis.
Review medications, pausing certain ones like anticoagulants.
During Procedure:
The patient is positioned comfortably with sterilization of the shoulder area.
Ultrasound guides the needle insertion and injection process.
The procedure lasts 30 minutes to an hour.
Post-Procedure:
Patients are observed briefly, manage mild pain with over-the-counter medications, and avoid strenuous activities for a few days.
Engaging in physical therapy maximizes the benefits, preventing recurrence.
Benefits and Risks
Benefits:
Improved accuracy and immediate pain relief.
Enhanced mobility and reduced inflammation.
Minimally invasive with a short procedure time.
Risks:
Rare risks include infection, bleeding, pain, allergic reactions, nerve damage, ineffectiveness, and joint instability.
Mitigating Risks:
Choose an experienced doctor, follow post-procedure instructions, and monitor for complications.
Long-Term Recovery and Rehabilitation
Physical therapy is crucial, focusing on stretching and strengthening exercises to maintain improved range of motion and prevent stiffness. Regular follow-up appointments ensure progress monitoring and treatment adjustments.
Conclusion
Ultrasound-guided hydrodilatation is an effective treatment for frozen shoulder, providing significant pain relief and improved mobility. This precise, minimally invasive procedure, combined with structured physical therapy and regular follow-ups, offers optimal results and helps prevent recurrence.
