Hydrodilatation for Frozen Shoulder
Hydrodilatation is an ultrasound-guided treatment for frozen shoulder, also known as adhesive capsulitis. Fluid, usually combined with local anaesthetic and a steroid, is carefully injected into the shoulder joint to gently stretch the tight joint capsule.
A frozen shoulder takes over your daily life. Reaching a seat belt, fastening a bra, getting a coat on, sleeping on that side — all of it becomes difficult, and it often goes on for months.
Frozen shoulder does usually settle on its own eventually, but “eventually” can mean one to three years. Hydrodilatation is one of the ways to stop waiting.
You may also see the procedure called hydrodistension, or spelled hydrodilation. These all describe the same treatment.
What hydrodilatation is for
In a frozen shoulder, the capsule surrounding the joint becomes inflamed, thickened and contracted. The shoulder loses movement, and beyond a certain point exercise alone struggles to restore it, because there is not enough room in the joint to move into.
Hydrodilatation aims to reduce pain and improve movement by distending that capsule directly. It is most useful when stiffness rather than pain is limiting progress with rehabilitation.
How hydrodilatation is done
The injection is performed under live ultrasound guidance. Placement is important, because the fluid has to reach the glenohumeral joint itself rather than the space above it, and the two are not reliably distinguished by feel alone. Guidance means the needle and the fluid are watched onto the target throughout.
The appointment lasts a full hour, which allows time to reassess the shoulder, carry out the procedure and explain what happens next.
Does hydrodilatation hurt?
Less than most people expect. The area is numbed with local anaesthetic first, and most patients describe the procedure itself as similar to having blood taken.
If you are anxious about it, say so — we will talk you through what is happening as we go.
Is hydrodilatation right for me?
Not every frozen shoulder needs hydrodilatation. Whether it is appropriate depends on how stiff the shoulder is, how long the problem has been going on, how painful it currently is, and what has already been tried.
A stiff, painful shoulder is also not always a frozen shoulder. Rotator cuff problems, calcific tendinopathy and arthritis can present in similar ways, and more than one can be present at once. Assessment normally begins with examination and diagnostic ultrasound, so that the cause of the restriction is established before any procedure is considered.
Where pain rather than stiffness dominates, an ultrasound-guided steroid injection into the joint may be a more appropriate first step.
Afterwards
Movement usually improves straight away. Your shoulder is reassessed immediately after the procedure, so you and the physiotherapist can see what range has been gained before you leave the clinic.
Treatment is then followed by a programme of exercises to help restore and maintain that movement.
This part is not optional. Hydrodilatation creates a period in which the shoulder can move further than it could before, and rehabilitation is what turns that into a lasting change. Without it, the capsule can tighten again.
The clinician who assesses your shoulder, scans it and carries out the hydrodilatation is the same one who then works with you on restoring movement. The procedure and the rehabilitation that follows it are planned together, by the person who has seen how your shoulder actually moves.
How much does hydrodilatation cost?
Every appointment lasts a full hour. Where a diagnostic scan is needed, that appointment is charged at the scan rate, which replaces the standard consultation fee rather than being added to it.
Current prices are listed on the prices page.
Hydrodilatation in Weybridge
Meyer Physio provides ultrasound-guided hydrodilatation at its clinic on Baker Street in Weybridge, Surrey. You can come to us directly, with no GP referral and no waiting list.
Your first appointment is a full hour of assessment, with a diagnostic scan where that will help, so that the cause of the restriction is established. Where hydrodilatation is the right next step, we explain what it involves and what to expect, and arrange the procedure once you have had time to consider it. If you already have a confirmed diagnosis, it can often be arranged sooner.
Written by Suegnet Meyer, Advanced Practice Musculoskeletal Physiotherapist and MSK Sonographer. HCPC registered [PH55635]. Chartered Society of Physiotherapy member [66175]. Last reviewed: 9 September 2026.