FROZEN SHOULDER INJECTION
Understanding Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, is a common condition characterised by pain, stiffness, and limited range of motion in the shoulder joint. It can have a significant impact on a person’s daily life, affecting sleep, mobility, and the ability to perform everyday tasks. At Alton Pain Clinic, we provide targeted treatment using ultrasound-guided frozen shoulder injections such as cortisone injections and hydrodilatation injections to help manage symptoms effectively and support recovery.
Our approach to managing frozen shoulder is grounded in the latest evidence and utilises the precision of ultrasound technology to deliver accurate injections directly into the affected joint. This method aims to reduce inflammation, relieve pain, and facilitate improved shoulder movement.
Common Symptoms
- Persistent shoulder pain, especially with movement
- Gradual onset of stiffness
- Limited range of motion (difficulty raising arm, reaching behindback, or rotating shoulder)
- Unbearable shoulder pain at night, which can make it difficult to sleep or lie comfortably on the affected side.
- Reduced pain but increased stiffness in later stages
- Significant loss of shoulder mobility
- Muscle weakness due to lack of use
- Pain radiating to the upper arm or neck
- Tenderness in the shoulder joint
- Difficulty with daily activities (e.g., dressing, reaching, lifting)
Frozen Shoulder Treatment
Ultrasound-Guided Cortisone Injections for Frozen Shoulder
At Alton Pain Clinic, we use corticosteroid injections—often referred to as cortisone injections—combined with local anaesthetic. This injection is delivered directly into the shoulder joint (typically the glenohumeral joint) under ultrasound guidance to ensure accuracy and efficacy.
Procedure
The procedure is straightforward, minimally invasive, and generally well tolerated. The steps include:
- The patient is seated or lying comfortably. The skin over the shoulder is cleansed with an antiseptic solution.
- Using high-resolution ultrasound, the practitioner visualises the glenohumeral joint and identifies the optimal injection site.
- A fine needle is inserted into the joint space under continuous ultrasound guidance.
- A corticosteroid and local anaesthetic mixture is injected.
The ultrasound-guided frozen shoulder injection typically targets the posterior or anterior glenohumeral joint recess, depending on the patient’s anatomy and symptom distribution.
Hydrodilatation for Frozen Shoulder
Hydrodilatation, also known as distension arthrography, is an alternative or adjunctive treatment for frozen shoulder offered at Alton Pain Clinic. This procedure involves injecting a larger volume of sterile fluid—usually a combination of saline, local anaesthetic, and corticosteroid—into the glenohumeral joint to gently stretch the joint capsule.
The goal of hydrodilatation is to disrupt adhesions and reduce capsular tightness, which can improve range of motion and relieve pain. The procedure is performed under ultrasound guidance for accuracy.
Procedure
- The patient is positioned comfortably and the skin is cleaned with antiseptic.
- Ultrasound is used to identify the joint capsule.
- A needle is inserted into the joint space, and a large volume of fluid is slowly introduced.
It is a safe and minimally invasive option for patients who have not responded to standard corticosteroid injections alone.
Your Care Pathway with us
- To book an appointment you can call our reception line, 0142084487, or email to info@altonpainclinic.co.uk or click the button given below.
- Comprehensive Musculoskeletal examination and testing.
- Same day Ultrasound Guided Injection for pain relief.
- Discussion of your treatment plan, treatment plan can include advanced treatments for example Cortisone Injections, Hyaluronic injections and various other options tailored to your specific needs.
What our Patients say?
Anatomy of the shoulder
The shoulder is a ball-and-socket joint that allows for a wide range of motion. It consists of three main bones:
- Humerus: The upper arm bone, which has a rounded head fitting into the socket.
- Scapula: The shoulder blade, which contains the glenoid cavity forming the socket.
- Clavicle: The collarbone, connecting the shoulder to the sternum (breastbone).
These bones are connected by a network of muscles, tendons, and ligaments that provide stability and facilitate movement. Key components include:
– Rotator Cuff: A group of muscles and tendons that surround the shoulder joint, enabling a wide range of motions.
– Capsule: A flexible, fibrous tissue that surrounds the shoulder joint, providing support and maintaining the joint’s integrity.
– Synovial Membrane: The lining of the joint capsule, producing synovial fluid to lubricate the joint and reduce friction.
Stages of Frozen Shoulder
Frozen shoulder progresses in three stages:
1. Freezing Stage: This stage involves a gradual onset of pain and increasing stiffness. Movement becomes more restricted over time, particularly with external rotation and elevation of the arm. Pain is often worse at night and may disturb sleep.
2. Frozen Stage: During this stage, the pain may reduce slightly, but stiffness remains. Patients often report difficulty with basic tasks such as reaching for objects or putting on clothes. The shoulder remains significantly restricted.
3. Thawing Stage: In this final phase, movement begins to return gradually, and pain continues to subside. Recovery may take months or even years without intervention.
Frozen shoulder is associated with thickening and tightening of the joint capsule around the glenohumeral joint. This leads to restricted movement, known as a capsular pattern, which limits external rotation, abduction, and internal rotation.
Diagnosis
Diagnosis of frozen shoulder is primarily based on the patient’s medical history and a physical examination. Your clinician at Alton Pain Clinic may ask you to move your shoulder in certain ways to check for pain and evaluate your range of motion. We use Ultrasound Scan for the diagnosis of Frozen Shoulder.
Benefits of Ultrasound-Guided Steroid Injections
- Targeted Pain Relief: The use of corticosteroids reduces inflammation, addressing the underlying cause of pain in frozen shoulder.
- Improved Range of Motion: Reducing inflammation allows patients to regain function more quickly.
- Accurate Delivery: Ultrasound guidance ensures the injection is placed precisely where it is needed, increasing effectiveness and reducing the risk of complications.
- Minimal Recovery Time: Patients can return to normal activity shortly after the procedure.
Benefits of Ultrasound-Guided Hydrodilatation
- Capsular Stretching: By introducing a larger volume of fluid into the joint, hydrodilatation helps to gently stretch the thickened joint capsule, addressing one of the core pathological features of frozen shoulder.
- Adhesion Disruption: The fluid pressure may help break down intra-articular adhesions, potentially improving joint movement and reducing stiffness.
- Pain Reduction: The corticosteroid component reduces inflammation within the joint capsule, leading to a decrease in pain over time.
Why Choose Alton Pain Clinic?
- Experienced clinicians specialising in ultrasound-guided frozen shoulder injections
- Personalised care plans tailored to individual needs
- Modern facilities and a patient-centred approach
Conclusion
At Alton Pain Clinic, we offer ultrasound-guided cortisone injections and hydrodilatation to support the management of frozen shoulder. These targeted treatments are delivered with precision to help reduce discomfort and improve movement, all within a professional and patient-focused setting.
FAQs About Frozen Shoulder
What is a frozen shoulder?
Frozen shoulder is a condition that causes pain, stiffness and restricted movement in the shoulder joint.
What are the symptoms of frozen shoulder?
Common symptoms include shoulder pain, stiffness and difficulty moving the arm, particularly when reaching overhead or behind your back.
How long does frozen shoulder last?
Frozen shoulder can take several months to improve, with recovery varying from person to person.
What is the best frozen shoulder treatment?
Treatment depends on the stage and severity of the condition and may include physiotherapy, pain relief, cortisone injections or hydrodilatation.
Are cortisone injections effective for frozen shoulder?
Cortisone injections may help reduce pain and inflammation, making it easier to move the shoulder.
What is hydrodilatation for frozen shoulder?
Hydrodilatation involves injecting fluid into the shoulder joint to help stretch the tightened capsule and improve movement.
Does frozen shoulder cause pain at night?
Yes. Frozen shoulder can cause significant pain at night, particularly when lying on the affected side. If your shoulder hurts at night, you may also experience disrupted sleep and increased stiffness when you wake.
Can frozen shoulder cause shoulder pain that is worse at night?
Yes. Frozen shoulder often causes shoulder pain that is worse at night, particularly during the painful early stage. This can make it difficult to sleep comfortably or lie on the affected shoulder.