Shoulder Hydro-dilatation & Manipulation

A small needle is inserted directly into the shoulder joint under ultrasound, or CAT Scan guidance. A small volume of contrast medium, long-acting local anaesthetic and steroid are then injected into the joint. The joint is then stretched with 20-30mLs of local anaesthetic and saline, occasionally resulting in a popping sensation. After the procedure you might experience a temporary feeling of tightness, increased pressure, or heaviness in the shoulder or down the arm, which may last a few hours.

There is no preparation required for your injection, but you will need to check with the provider if you need to arrange for someone to drive you home. The procedure generally takes around 30 minutes.

Your injection appointment at the radiology clinic is coordinated with an immediate post injection physiotherapy consultation which can be organised through the office staff at our practice. Immediately following your injection procedure, you will be seen at our practice where we will assess your shoulder movement and then perform gentle soft tissue work and a series of gentle shoulder joint stretches. This is usually well tolerated as the local anaesthetic in your shoulder will still be active. During the procedure you may feel a popping sensation which is the thickened capsular joint tissue stretching.

The procedure affords improvement in the vast majority of people. The degree of improvement varies from person to person, but you can expect to achieve a reduction of pain and an increase in your shoulder movement.

Many people feel immediate pain relief, but for some it can take 2-4 weeks to achieve full benefit which is assisted with the with the aid of physiotherapy and a home exercise program.

There are very few side effects from hydrodilatation injection. A mild allergy to the cortisone or local anaesthetic may occur, usually manifested by rash, and may last for a day or two. The most serious potential complication is infection in the joint. If your shoulder becomes hot and red or you develop a fever, chills, or sweats, please contact your doctor immediately, or attend your local emergency department.

At your initial post injection physiotherapy consultation your physiotherapist will provide further advice on safe exercises to improve your shoulder range of movement. It is important to maintain your exercise program for a period (typically for 1-2 months) following your injection and manipulation to maintain the range that is recovered. A common side effect following injection is a transient increase in pain, termed a flare, which can occur in first 4- 48hrs. Treatment with simple analgesic measures such as Panadol, and cold packs is all that is usually required. The steroid may cause facial flushing/redness, which can last a few days and you my experience disturbed sleep typically in the first night following the injection. If you have Diabetes, you may notice a rise in blood sugar levels for up to 1 week.