Oct 14, 2013

A new treatment option for frozen shoulder

One condition I’ve seen many times in my clinic is frozen shoulder, a debilitating condition estimated to affect up to 1 in 20 people (so chances are you know someone who has or has had frozen shoulder!). Today, I want to tell you about a new, simple treatment method: hydrostatic distension.

What is frozen shoulder?

Frozen shoulder – also known as adhesive capsulitis – is when the connective tissue surrounding the glenohumeral joint becomes inflamed and stiff, resulting in reduction of movement. Most people who get frozen shoulder are 40-60 years old, and those with diabetes, lung and heart disease, and sports injuries are at a higher risk. It usually takes between 18 and 24 months to recover with stages of pain and stiffness. Daily tasks, such as lifting a kettle, can become difficult, and certain movements or bumps can cause sudden and intense pain and cramping. With such a long recovery time, this condition is obviously frustrating for patients!

Until recently, treatments have so far been limited to ice or heat pain relief, anti-inflammatories, physiotherapy and surgery. But what about a simple method that brings quick and lasting relief, saving months of painkillers? My colleague Dr Syed Babar and I have recently pioneered a new technique – hydrostatic distension.

The process involves the administering of two injections, two weeks apart, under ultra-sound guided conditions as an out-patient. The shoulder is initially assessed clinically, and usually followed by an MRI scan. Then a mixture of local anaesthetic, saline and a small amount of steroid is injected into the glenohumeral joint. The joint is re-inflated, breaking down the adhesions and distending the capsule.

Syed and I have treated around 120 patients. What are the benefits we’ve found of this method?

  • 80% of patients are pain-free after a month – avoiding 18-24 months of stiffness!
  • Relief is felt almost instantaneously, after the first injection
  • It’s quick (10 minute) and a straightford procedure
  • There’s only minor discomfort during injections
  • It’s cost effective (less physio sessions to attend)
  • You avoid surgery

I feel that this is a great new possibility to consider – hopefully it becomes more popular in the future.

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