Hydrodilatation for Frozen Shoulder: Effective Treatment Explained
An ultrasound-guided injection technique that is commonly used to treat pain from Frozen shoulder. Learn more below.
Delivered by a GMC-registered doctor in Manchester and Burnley.
CQC Regulated Clinic
Ultrasound Guided Procedure
No GP Referral Required
Manchester and Burnley Clinic
INTRO
Introduction
Dealing with a frozen shoulder? Learn how hydrodilatation for frozen shoulder can help. This article explains what hydrodilatation for frozen shoulder is, how it works, and whether it’s effective for treating frozen shoulder.
Hydrodilatation is a treatment for frozen shoulder that helps relieve pain and improve mobility by injecting a high-volume saline and corticosteroid solution into the shoulder joint.
The procedure is guided by ultrasound for accuracy and is much less invasive than surgery, often helping people regain shoulder movement more quickly.
Post-procedure care, including physical therapy, is essential for maximising recovery and ensuring long-term benefits of hydrodilatation.
Understanding Frozen Shoulder
Frozen shoulder, also called adhesive capsulitis, occurs when the tissue around the shoulder joint becomes inflamed and tight, causing stiffness and limiting movement in all directions.
This condition can be triggered by several factors, including underlying medical conditions such as diabetes and thyroid disease, or following an injury or surgery that limits the normal movement of the affected arm.
The symptoms of frozen shoulder and other shoulder problems often develop gradually, starting with pain that gets worse at night and eventually leading to stiffness that makes everyday tasks difficult.
Recovering from a frozen shoulder can be a long and frustrating process, sometimes taking up to two years. During this time, stiffness can make simple tasks like dressing, driving, or even sleeping difficult. Because it can significantly affect your quality of life, finding effective treatment is essential.
Effectively managing frozen shoulder requires finding the right balance between gentle movement and rest. While it’s essential to avoid immobilising the arm completely, engaging in gentle movements and exercises can help alleviate pain and prevent further stiffness.
Understanding the complexities of frozen shoulder is key to finding the most effective treatment. With the right approach, you can find relief from the pain and restore your shoulder’s range of motion, enabling you to return to your daily activities with greater ease.
There are some treatments that can ease Frozen Shoulder symptoms and make recovery a more streamlined process. In this article we discuss Shoulder Hydrodilatation but another treatment that can be used are cortisone injections.
WHAT IS IT?
What is Shoulder Hydrodilatation?
Hydrodilatation is a relatively new injection technique designed to treat frozen shoulder. This procedure involves injecting a mixture of saline solution, corticosteroids, and local anaesthetic into the shoulder glenohumeral joint to expand the joint space using hydraulic pressure.
The main goal of shoulder hydrodilatation is to ease pain, reduce inflammation, and gently stretch the joint capsule, which helps improve shoulder mobility.
Patients should also explore other treatment options and additional treatments before considering hydrodilatation. While hydrodilatation can offer significant benefits, it’s important to consult a healthcare professional to find the treatment plan that’s best for your specific situation.
How Hydrodilatation Works
Hydrodilatation is an effective treatment for frozen shoulder that helps relieve pain and improve mobility. Its main goal is to ease discomfort and restore shoulder movement by stretching the joint capsule and breaking up adhesions that limit motion.
During the procedure, a saline solution combined with cortisone is injected into the shoulder joint, along with a local anaesthetic to numb the area and provide immediate pain relief.
One of the key components of hydrodilatation is the use of ultrasound guidance to ensure precise needle placement. This technique has been proven highly effective in relieving symptoms and helping patients regain their range of motion. By combining the anti-inflammatory effects of corticosteroids with the mechanical stretching of the joint, hydrodilatation offers a powerful treatment option for frozen shoulder.
Comparing Hydrodilatation with Other Treatments
Hydrodilatation is considered a less invasive alternative to surgery for patients suffering from frozen shoulder. Compared to steroid injections alone, hydrodilatation offers better improvement in shoulder disability and passive external rotation.
This procedure combines the anti-inflammatory effects of corticosteroids with gentle stretching of the joint capsule, providing a more complete approach to treating frozen shoulder.
Compared to physical therapy alone, hydrodilatation can provide faster and more noticeable improvements in shoulder mobility. It’s also a cost-effective option, less expensive than surgery while still delivering significant benefits. Studies show that hydrodilatation can notably improve passive external rotation both in the short and long term, making it a viable choice for many patients.
Recent evidence shows that hydrodilatation offers temporary improvements in disability, with long-term outcomes similar to those of cortisone injections. Additionally, it helps improve both passive internal and external rotation, providing a well-rounded solution for those dealing with frozen shoulder.
SUITABILITY
Ideal Candidates for Hydrodilatation
Unresponsive to Conservative Treatments:
Physical therapy or medications haven’t improved your condition
Lack of Improvement after a Cortisone Injection:
If you’ve tried physical therapy and a cortisone shot without success, hydrodilatation might be a suitable next step.
Pain Interfering with Daily Activities:
If shoulder pain disrupts tasks like reaching behind your head or everyday movements, hydrodilatation could help.
Severe Stiffness:
Individuals with significant shoulder stiffness that limits normal activities may benefit greatly from this procedure.
For manageable pain and mild restrictions, exploring other treatments first is advisable before opting for hydrodilatation. This approach ensures the most suitable treatment for your specific condition. Book a consultation with us to find out about your next options.
PREPARATION
Preparing for the Procedure
Proper preparation is crucial for the success of hydrodilatation. Performing imaging tests like X-rays, ultrasounds, or MRI imaging is essential to eliminate other potential shoulder conditions before proceeding. These tests confirm the diagnosis of frozen shoulder and rule out other underlying issues that could complicate the procedure. At MyMSK Clinic the doctor would perform an ultrasound scan during the consultation to find out what is going on.
A thorough medical history and physical exam are key when preparing for hydrodilatation. These assessments help determine if the procedure is the right choice for you, ensuring it’s a good fit for your condition.
Patients should inform their doctor about all medications and supplements they’re taking, as some, particularly anticoagulants, may need to be stopped temporarily before the procedure.
Preparing for the procedure involves stopping specific medications as directed by the healthcare provider. Following these preparatory steps ensures a smoother and more effective hydrodilatation procedure that is performed correctly.
At My MSK Clinic we recommend booking in for an initial consultation. This allows our doctor to take a thorough history and perform a detailed examination. This includes a ultrasound scan of the shoulder. During the consultation the doctor will make a personalised treatment plan that suits you best. If Shoulder Hydrodilatation is suitable and safe this can be done during the same consultation.
THE PROCEDURE
Step-by-Step Guide to the Hydrodilatation Procedure
Treating Frozen Shoulder with hydrodilatation is a straightforward and structured process at My MSK Clinic in Manchester. The procedure itself usually takes around 15 to 30 minutes, and you’ll go home the same day.
- Step 1: Consultation and Assessment
Your appointment begins with a consultation with a GMC-registered doctor, who will review your symptoms, medical history and previous treatments. A physical examination helps confirm the diagnosis, and any imaging you’ve had (MRI or CT) is reviewed to pinpoint the source of your pain. At My MSK Clinic we also use our Ultrasound Scanner to further guide decision making.
- Step 2: Ultrasound-guided Shoulder Hydrodilatation
The procedure begins with cleaning the skin with an anti bacterial sterile solution and administering a local anesthetic to numb the area. This step is crucial to minimise discomfort during the injection process. An ultrasound scanner guides the needle placement, ensuring accuracy and reducing the risk of complications.
Once the needle is properly positioned, a local anesthetic may be injected to confirm the placement. Then, a mixture of steroid, local anesthetic, and saline (30-35ml) is injected into the shoulder joint. This combination helps stretch the joint lining, reduce inflammation, and provides quick pain relief.
The procedure typically lasts about 10 to 15 minutes, making it a relatively quick and straightforward process. Ultrasound guidance enhances the injection’s accuracy, ensuring the treatment is delivered precisely where needed.
AFTERCARE
Post-Procedure Care and Recovery
After hydrodilatation, managing post-procedure pain is crucial for a smooth recovery time. Over-the-counter pain relief and ice packs help alleviate any discomfort. Patients should avoid heavy exercise or putting strain on the injected shoulder for 24-48 hours, and steer clear of strenuous activities for at least a few hours after the procedure.
Immediate application of physiotherapy exercises post-procedure is crucial for regaining shoulder mobility. These exercises help maintain the improvements achieved and prevent the shoulder from becoming stiff again.
Monitoring for new symptoms such as redness or increased pain is important. Patients should track their symptoms and report any persistent issues to their healthcare provider.
After the treatment is completed, at My MSK Clinic, the doctor will provide you with information on the aftercare process. The doctor will explain or recommend the most suitable exercises you should follow personalised to you.
Hydrodilatation Success Rates
Hydrodilatation is one of the most widely used non-surgical treatments for frozen shoulder (adhesive capsulitis). Reported success rates vary depending on how success is measured, whether that is pain relief, range of movement, patient satisfaction or a return to near-normal function. The figures below are grouped by outcome, with a linked source for each.
- Pain improvement: a reported success rate of over 90% for improving shoulder pain, as set out in published patient information on shoulder hydrodilatation.
- Range of movement: a reported success rate of over 70% for improving shoulder movement, from the same patient information on shoulder hydrodilatation.
- Patient satisfaction: in a randomised trial summarised in a peer-reviewed review of hydrodilatation, 94% of patients treated with hydrodilatation were satisfied at six months, compared with 81% treated by manipulation under anaesthetic.
- Return of function: the same review reports that around 63% of patients regained normal or near-normal shoulder function at a mean of 14 months’ follow-up.
As with any treatment, results vary between individuals. Improvement is usually best when the procedure is followed by physiotherapy, and outcomes can be less predictable in people with diabetes. Hydrodilatation is generally most effective as a short-to-medium-term treatment, and some patients may need a repeat procedure or further management.
Benefits and Risks
Hydrodilatation offers immediate pain relief, enhanced mobility, and reduced inflammation. About 95% of patients report reduced pain and improved movement after hydrodilatation, with 75% reporting a good or excellent overall response.
Like any medical procedure, hydrodilatation does come with some risks. While most patients experience only mild discomfort or pain after the injection, there’s a small risk of infection, typically less than 1 in 1000 cases.
Other potential risks include allergic reactions, temporary dizziness, and a flare reaction causing temporary increased painful side effects. Rare complications like nerve damage or temporary joint instability may also occur.
Despite these risks, the benefits of hydrodilatation often outweigh the potential complications. A thorough assessment by a healthcare professional can determine if this procedure is right for you.
Long-Term Effects and Rehabilitation
For long-term success with hydrodilatation, it’s important to include physical therapy as part of the treatment plan. Physical therapy is key in improving pain relief and mobility for frozen shoulder patients. Regular stretching during rehab helps maintain shoulder flexibility and reduces the risk of stiffness returning.
Strengthening exercises should be progressively introduced during rehabilitation to restore muscle function and support shoulder stability. Therapists recommend gradually increasing exercise intensity and duration as the patient’s condition improves. This approach ensures the shoulder remains strong and functional long term, reducing the likelihood of recurrence.
Following a comprehensive rehabilitation plan maximises the significant benefit of hydrodilatation and ensures sustained improvements in shoulder mobility and function.
COST
How Much Does Hydrodilatation for Frozen Shoulder Cost?
From
£350
We keep our pricing simple and transparent. Shoulder hydrodilatation at MyMSK Clinic is carried out by a GMC-registered doctor, using ultrasound guidance for accurate placement, in a clinic that is registered with the Care Quality Commission (CQC). The Hydrodilatation Procedure costs £350 at My MSK Clinic.
We recommend booking an initial consultation with us, which will allow the doctor to take a thorough history and do a detailed examination of the shoulder, to determine whether the hydrodilatation procedure is right for you. If Hydrodilatation is not suitable the doctor may suggest an alternative option such as a Cortisone Injection.
Appointments are available at both our Manchester clinic (Sevendale House, 7 Dale Street, M1 1JA) and our Burnley clinic (1A Parker Street, BB11 1AU), often within the same week.
What's Included in the Cost?
✔ Consultation with Dr Amir Akhtar (GMC : 6159060)
✔ Ultrasound Scan and examination
✔ Local Anaesthetic to ensure Comfort throughout the Procedure
✔ Any on the Day Medications
✔ The Hydrodilatation Procedure
WHY MYMSK
Why Choose My MSK Clinic?
Ultrasound Accuracy
All our injections are done under Ultrasound Guidance.
Same Day Option
Diagnosis and Injections usually done at same appointment
No Waiting List
You can Self Refer directly to MyMSK Clinic – No Referral required.
OUR CLINICS
Where We Offer Hydrodilatation for Frozen Shoulder
We treat patients at two clinics in the North West. Easy to reach for Greater Manchester, Salford, Bury, Bolton, Oldham and the wider Lancashire area.
Summary
Hydrodilatation is a promising treatment option for those suffering from frozen shoulder, offering significant benefits like immediate pain relief and improved mobility.
This procedure offers an effective alternative to more invasive treatments, combining the benefits of corticosteroids with gentle stretching to provide thorough relief.
If you or someone you know is struggling with the debilitating effects of frozen shoulder, hydrodilatation could be the solution you’ve been searching for. Consult with one of our specialists about whether this treatment is right for you.
FAQs
Frequently Asked Questions
What is frozen shoulder, and what causes it?
Frozen shoulder, or adhesive capsulitis, causes pain and stiffness in the shoulder due to inflammation in the surrounding tissue. It can be triggered by conditions like diabetes and thyroid disease, as well as injuries or surgeries that limit arm movement. For more information regarding frozen shoulder please visit our dedicated page.
How does hydrodilatation work to treat frozen shoulder?
Hydrodilatation treats frozen shoulder by injecting a saline solution, corticosteroids, and local anesthetic into the joint, which stretches the capsule, reduces inflammation, and enhances mobility. This ultrasound-guided technique effectively alleviates pain and improves range of motion.
What makes someone an ideal candidate for hydrodilatation?
An ideal candidate for hydrodilatation is someone who has not found relief from conservative treatments or a steroid injection, experiences significant pain affecting daily activities, and suffers from severe shoulder stiffness.
What should I expect during the hydrodilatation procedure?
During the hydrodilatation procedure, your skin will be cleaned, and a local anesthetic will be applied. Then, a mixture of steroid, local anesthetic, and saline will be injected into your shoulder joint under ultrasound guidance. The entire process takes about 10 to 15 minutes.
What are the potential risks and side effects of hydrodilatation?
Hydrodilatation carries risks such as mild pain after the injection, infection, allergic reactions, and rare instances of nerve damage or joint instability. While these side effects are possible, the benefits typically outweigh the associated risks.
References:
- Rymaruk S, Peach C. Indications for hydrodilatation for frozen shoulder. EFORT Open Reviews. 2017;2(11):462–468. doi:10.1302/2058-5241.2.160061.
- Patient information leaflet: Shoulder Hydrodilatation. Available online (accessed July 2026).
Considering Hydrodilatation in Manchester?
Ultrasound-guided. No GP referral needed. 7 minutes from Manchester Piccadilly.
PAGE MEDICALLY REVIEWED BY DR AMIR AKHTAR JULY 2026
Dr Amir Akhtar
Our Reviews
The injection has helped me greatly and I would not hesitate to recommend Dr Akhtar for any treatments in his clinic.
Fantastic service.
The injection has helped me greatly and I would not hesitate to recommend Dr Akhtar for any treatments in his clinic.
Fantastic service.
I feel much more confident about the treatment plan we discussed. I can highly recommend his service.
Michael P.
I feel much more confident about the treatment plan we discussed. I can highly recommend his service.
Michael P.
I saw Dr Amir Akhtar for a painful recurrence of sesamoiditis / forefoot pain. He assessed the area carefully, used ultrasound to check what was going on, and only proceeded with injection once he was satisfied it was appropriate. I valued that he was clear, direct, and clinically grounded rather than just rushing through the appointment.
He also explained the wider mechanical picture well, including how compensation from other ankle problems may be contributing. The treatment was carried out there and then, and the whole process felt efficient and professional.
A helpful and thorough service. I would recommend them.
I saw Dr Amir Akhtar for a painful recurrence of sesamoiditis / forefoot pain. He assessed the area carefully, used ultrasound to check what was going on, and only proceeded with injection once he was satisfied it was appropriate. I valued that he was clear, direct, and clinically grounded rather than just rushing through the appointment.
He also explained the wider mechanical picture well, including how compensation from other ankle problems may be contributing. The treatment was carried out there and then, and the whole process felt efficient and professional.
A helpful and thorough service. I would recommend them.
Overall, I would certainly recommend this clinic and clinician. It was excellent care. I am pleased to say that I am noticing some improvement in my knee following the injection and am now saving to have my other knee treated. I will definitely be returning to this clinic.
Overall, I would certainly recommend this clinic and clinician. It was excellent care. I am pleased to say that I am noticing some improvement in my knee following the injection and am now saving to have my other knee treated. I will definitely be returning to this clinic.
She received ultrasound guided hydrodissection of the Baxter’s nerve, and since the treatment she has reported a really positive improvement. Her pain has reduced significantly, and she feels much better in herself, more comfortable driving and able to go out for walks again, which she hasn’t been able to do for quite some time.
The improvement has been remarkable and we’re very grateful. She has also noticed that she is now able to move her toe more easily, and the pain in her heel at night has reduced, helping her rest more comfortably.
Thank you for the care, support, and treatment it has made a real difference.
She received ultrasound guided hydrodissection of the Baxter’s nerve, and since the treatment she has reported a really positive improvement. Her pain has reduced significantly, and she feels much better in herself, more comfortable driving and able to go out for walks again, which she hasn’t been able to do for quite some time.
The improvement has been remarkable and we’re very grateful. She has also noticed that she is now able to move her toe more easily, and the pain in her heel at night has reduced, helping her rest more comfortably.
Thank you for the care, support, and treatment it has made a real difference.
I definitely feel the injection has worked and I'm hoping it allows me to get some quality of life back.
I definitely feel the injection has worked and I'm hoping it allows me to get some quality of life back.
Dr AKhtar has your best interests at heart at al time. Dr AKhtar was really thorough when. investigating my hip and knee.
It was so refreshing to meet Dr Akhtar,
I will recommend him to my family and friends should they need a specialist.
Dr AKhtar has your best interests at heart at al time. Dr AKhtar was really thorough when. investigating my hip and knee.
It was so refreshing to meet Dr Akhtar,
I will recommend him to my family and friends should they need a specialist.
I booked my appointment online and got so much more than I expected on the day of my appointment.
The level of detail that things were explained to me in was fantastic but also done in such a way that it wasn’t overwhelming. I’m at the start of a journey to recovery but have so much confidence I am in great hands and off to the best possible start!!
The evening following my appointment I received some emails of; advice, follow up care, recommendations of the best splint to purchase, images taken from my scans and even a copy of my letter that is going to the GP!
What a fantastic service, one would have to wait weeks if not months for this kind of feedback on the NHS and the cost of everything was very reasonable too.
Thank you very much for everything , I really appreciate your time and approach towards my issue.
I booked my appointment online and got so much more than I expected on the day of my appointment.
The level of detail that things were explained to me in was fantastic but also done in such a way that it wasn’t overwhelming. I’m at the start of a journey to recovery but have so much confidence I am in great hands and off to the best possible start!!
The evening following my appointment I received some emails of; advice, follow up care, recommendations of the best splint to purchase, images taken from my scans and even a copy of my letter that is going to the GP!
What a fantastic service, one would have to wait weeks if not months for this kind of feedback on the NHS and the cost of everything was very reasonable too.
Thank you very much for everything , I really appreciate your time and approach towards my issue.
Thanks 😊
Thanks 😊
Dr Akhtar was everything you could hope for in a specialist: friendly, incredibly knowledgeable, and, most importantly, truly listened. He took the time to understand my pain and concerns, and for the first time since the accident, I genuinely felt hopeful. I’m only 48 hours post-injection, but already the difference in my outlook is huge.
A special thank you goes to Safi, who has been nothing short of exceptional. Safi has handled my endless emails with patience, kindness, and professionalism, and their support has made this whole process so much easier. They genuinely deserve recognition for outstanding customer care.
I was originally going to wait seven days before leaving a review, but honestly, this clinic has already proven itself. I would return here time and time again without hesitation, and I would recommend My MSK to absolutely anyone in need of expert, compassionate care.
Thank you to Dr Akhtar, Safi, and the entire team for giving me hope again. An effortless 5 stars. 🌟🌟🌟🌟🌟
Dr Akhtar was everything you could hope for in a specialist: friendly, incredibly knowledgeable, and, most importantly, truly listened. He took the time to understand my pain and concerns, and for the first time since the accident, I genuinely felt hopeful. I’m only 48 hours post-injection, but already the difference in my outlook is huge.
A special thank you goes to Safi, who has been nothing short of exceptional. Safi has handled my endless emails with patience, kindness, and professionalism, and their support has made this whole process so much easier. They genuinely deserve recognition for outstanding customer care.
I was originally going to wait seven days before leaving a review, but honestly, this clinic has already proven itself. I would return here time and time again without hesitation, and I would recommend My MSK to absolutely anyone in need of expert, compassionate care.
Thank you to Dr Akhtar, Safi, and the entire team for giving me hope again. An effortless 5 stars. 🌟🌟🌟🌟🌟
Got an appointment really quickly and the consultation was in depth with a scan showing me the exact problem. Treatment options were given to me with associated costs along with exercises to support in the interim.
Dr Akhtar is really helpful and knowledgeable and I can’t thank him enough for his support which included a direct referral to hospital for other support.
Thank you
Got an appointment really quickly and the consultation was in depth with a scan showing me the exact problem. Treatment options were given to me with associated costs along with exercises to support in the interim.
Dr Akhtar is really helpful and knowledgeable and I can’t thank him enough for his support which included a direct referral to hospital for other support.
Thank you
I had an amazing experience with this company.
Dr Akhtar was reliable, honest and operates with integrity.
I would highly recommend MYMSK Clinic.
I had an amazing experience with this company.
Dr Akhtar was reliable, honest and operates with integrity.
I would highly recommend MYMSK Clinic.
Took my partner to see amir
Could not praise him highly enough
Partner was in pain for 5 days,hardly any sleep.after a few cortisone injections she was able to sleep.
Dr amir tells you the way it is
Did a full report for the gp recommending future action required
Then we got a phone call today of amir to see how my partner was doing.
Dr akhtar very professional in his work
Took my partner to see amir
Could not praise him highly enough
Partner was in pain for 5 days,hardly any sleep.after a few cortisone injections she was able to sleep.
Dr amir tells you the way it is
Did a full report for the gp recommending future action required
Then we got a phone call today of amir to see how my partner was doing.
Dr akhtar very professional in his work
From the very beginning, Dr. Akhtar showed exceptional professionalism, honesty and genuine care, taking the time to explain the procedure in detail and addressing all my concerns.
He explained any symptoms that may occur post injection and the time for it to become effective.
Thank you doctor!
From the very beginning, Dr. Akhtar showed exceptional professionalism, honesty and genuine care, taking the time to explain the procedure in detail and addressing all my concerns.
He explained any symptoms that may occur post injection and the time for it to become effective.
Thank you doctor!
I felt really at ease and was able to explain what was wrong with me in a relaxed atmosphere.
Can ‘t recommend enough
Also the building is so beautiful inside😊
I felt really at ease and was able to explain what was wrong with me in a relaxed atmosphere.
Can ‘t recommend enough
Also the building is so beautiful inside😊
He was very informative about what he was going to do and what was causing the issue.
He was very friendly and I will 100% be recommending his services to anyone that needs help.
He was very informative about what he was going to do and what was causing the issue.
He was very friendly and I will 100% be recommending his services to anyone that needs help.
I would highly recommend this clinic, very professional staff, with special commendation to Dr Akhtar. An experienced clinician in the field of MSK medicine, a credit to his profession!
I would highly recommend this clinic, very professional staff, with special commendation to Dr Akhtar. An experienced clinician in the field of MSK medicine, a credit to his profession!
However during the consultation Dr Aktar explain that the injection might not be the best course of action, he gave me some excellent advice and explained in detail what was wrong and how that was causing the painful symptoms.
I left feeling much more informed about my situation and after following his instructions my symptoms have improved massively.
I really appreciated the good advice and felt it was far more beneficial than other places who would have just taken my money for the injection and not really considered the actual root cause.
However during the consultation Dr Aktar explain that the injection might not be the best course of action, he gave me some excellent advice and explained in detail what was wrong and how that was causing the painful symptoms.
I left feeling much more informed about my situation and after following his instructions my symptoms have improved massively.
I really appreciated the good advice and felt it was far more beneficial than other places who would have just taken my money for the injection and not really considered the actual root cause.
Would recommend to anyone!
Would recommend to anyone!
certification
GMC Registered Doctor and CQC Regulated Clinic
