Hydraulic distention and frozen shoulder management

This study discusses a technique called hydraulic distension for frozen shoulder.  What is hydraulic distension?  The technique involves inserting a needle into the front of the shoulder joint and injecting lidocaine, a numbning agent, triamcinolone, which is a steroid, and then about 40 ml of chilled saline solution forcibly injected into the joint space. This helps to stretch and separate the frozen joint and improve range of motion and help with the  pain.

For people who want to try conservative measures, you may want to consider an in-office treatment that I do called, Trigenics.  I even set up a YouTube Channel of “before-and-after” videos of people treated for shoulder problems with Trigenics.

Frozen shoulder is a commonly found disorder that is both painful and debilitating to a patient. Currently, no standard treatment protocol is universally accepted for the management of frozen shoulder.

The authors of this study examine the effectiveness of hydraulic distention, also known as hydroplasty, as a fast, inexpensive, low risk manoeuvre for the management of frozen shoulder.

For this study, 80 subjects with 88 frozen shoulders in total were evaluated for hydraulic distention intervention. The authors used the diagnostic criteria of shoulder range of motion limitation that was caused by the absence of trauma, and typical range of motion limitations. Of the 88 shoulders evaluated, 5 had previously had steroidal injections, and 50 had been treated with non-steroidal anti-inflammatory (NSAIDs) medication, but without much relief.

The authors conducted hydraulic distention on each of the shoulders, noting improvements in range of motion immediately following the procedure as well as 6 weeks later at a follow-up session. Of the 88 shoulders treated, 8% of the subjects had excellent results, 48% good results, 40% fair results and 12% had poor results.

At follow up, the authors noted that 44% had excellent results, 50% had good results, 12% had fair results and 2% had poor results. Diagnostic criteria for improvementwere gains in range of motion, decrease in pain, and functional use of the shoulder immediately following the procedure, and at 6 weeks follow-up.

While this article does support both the immediate and longer-term improvements from hydraulic distention, the outcome measures used to note progress with functional gains are vague, and more targeted data is needed for to be able to assess specific benefits.

Additionally, the use of exercise therapy following hydraulic distention would be good to note with regards to maintaining and improving pain levels and function gains.

Not that familiar with the topic of hydrolic distention (hydroplasty)? Additional info can be found here!

From: Mishra et al., Int J Orthop Sci 3 (2017) 675-677. All rights reserved to the International Journal of Orthopaedics Sciences. Click here for the online summary.