Glenohumeral Capsular Distension/Hydro-Dilation

Pain Management

What are Capsular Distension/Hydro-Dilation?

A capsular distension/hydro-dilation is an injection therapy done under fluoroscopic guidance (low dose, live x-ray) aimed to treat frozen shoulder/adhesive capsulitis by injecting a large volume of fluid (up to 50cc) containing a combination of saline, anesthetic and corticosteroid into the glenohumeral joint. By injecting this large volume of fluid, its purpose is to distend the joint capsule until it potentially ruptures, this will then increase the shoulder mobility. When this happens, you can feel immense discomfort and a “release” when the capsule ruptures.

Capsular distensions are often used as both a diagnostic and therapeutic tool.

As a diagnostic tool, Capsular distensions in the glenohumeral joint can aid in the identification of the source of pain if relief is experienced.

For information about the post care instructions, click here.

FAQs

How do we know the medication is in the correct location?

Capsular distension is guided by fluoroscopy (low dose, live x-ray) and the location is confirmed with x-ray contrast (dye).

What can I expect at my appointment?

Once you arrive at the clinic you will be asked to complete a few forms pertaining to the appointment. To allow adequate time for this, please do arrive 15 minutes prior to your scheduled appointment time. You may be instructed to change into a gown for your procedure.

You will be taken back to a private exam room for your procedure. One of our technologists and a Radiologist will review your previous diagnostic imaging, discuss the reason for your referral to Beam Radiology, and explain the details of the recommended pain management treatment.

Communication is very important to Beam, and you will be given the opportunity to ask any questions you may have before beginning. You will be asked to lay down on the exam table on your back, exposing your shoulder. The targeted area will be cleaned and sterilized. To ensure effectiveness and accuracy, fluoroscopy will be used in real-time to guide the injection. Fluoroscopy is a type of X-ray imaging. The Radiologist will inject a local anaesthetic to numb the area, followed by a large volume of fluid containing a combination of saline, anaesthetic and corticosteroid into the glenohumeral joint.

Following your injection, you will be directed to our recovery area for a brief observation period. One of our Nurses will review the post-procedure care with you, and then you will be free to leave the clinic.

What are my expected results post injection?

With successful treatment, pain relief can last weeks or years. It is important to note that the steroid injected is expected to take effect between 2-5 days, with full effect or pain relief taking place between one and two-weeks post-injection. With sufficient pain relief, a physiotherapy regime is then recommended to strengthen muscles and prevent future flare ups.

What are the risks associated with my injection?

This procedure is performed using a sterile technique, very rare complications include allergic reaction, infection, and bleeding.

If you have diabetes, you may experience a temporary elevation in you blood sugar as a result of the corticosteroid (cortisone) medication. If you monitor your blood sugar, you may have to adjust your medication accordingly. Common side effects of cortisone can include temporary flushing (warmth and redness) in the face, neck, and chest, as well as temporary sleep disruption. If you experience these side effects, they will resolve on their own over the course of the week.

What is the Post-Care following this treatment?

Keep the area clean and dry. Avoid hot tubs, pools, or baths for 48 hours. You can shower normally.

You can perform your normal daily activities but avoid strenuous activities for the next 3-4 days following the treatment.

For information about the post care instructions, click here.