When You Can't Reach the Top Shelf
It began as an ache. Now you can't fasten a bra, reach a back pocket or lift a cup from the top shelf. Night pain wakes you when you roll onto that side.
- Pain and stiffness that slowly increase over weeks or months.
- Loss of movement in every direction, especially turning the arm outward.
- Night pain is common in the early stage.
Pain with lifting but normal movement may be a rotator cuff problem instead. See our shoulder pain guide.
The Three Stages of Frozen Shoulder
- Freezing: pain increases and movement starts to tighten.
- Frozen: pain may ease but stiffness is at its worst.
- Thawing: movement slowly returns.
Knowing the stage helps decide which treatment is most useful.
Established Care Comes First
- Pain relief and gentle movement to keep the shoulder working.
- Physiotherapy with stretching suited to the stage.
- Steroid injection into the joint to ease pain in the early stage.
- Good diabetes and thyroid control where relevant.
How Hydrodilatation for Frozen Shoulder Works
Under ultrasound or X-ray guidance, a doctor injects a larger volume of fluid into the joint capsule.
- The fluid stretches the tight capsule from the inside.
- A steroid is often added to calm inflammation.
- Physiotherapy starts soon after to keep the gained movement.
- It is usually done as an outpatient procedure.
Comparing the Main Options
| Option | Main purpose | Evidence | Key cautions |
|---|---|---|---|
| Physiotherapy | Restore movement | Standard care | Takes time |
| Steroid injection | Ease early pain | Good short-term | Blood sugar rise in diabetes |
| Hydrodilatation | Stretch the capsule | Promising short to medium-term | Temporary soreness |
| Release surgery | Severe, lasting stiffness | Used when others fail | Surgical and anaesthetic risks |
Where Regenerative Options Fit
Some people ask about cell-based or anti-inflammatory infusions for shoulder pain.
- Evidence in frozen shoulder specifically is very limited.
- They may be discussed only alongside physiotherapy, not instead of it.
- Any option needs a clear goal and review point.
Learn more on our MSC therapy page.
Questions to Ask Your Doctor
- Which stage is my frozen shoulder in?
- Is hydrodilatation suitable now, or should I try physiotherapy first?
- How will diabetes or other conditions affect treatment?
- What exercises should I do after the procedure?
Medical References
- NHS. Frozen shoulder
- American Academy of Orthopaedic Surgeons, OrthoInfo. Frozen Shoulder
- MedlinePlus, U.S. National Library of Medicine. Frozen shoulder
Talk to a Doctor Before You Decide
Tell us how long your shoulder has been stiff, which movements are limited and what treatments you have tried. Our doctors can review whether hydrodilatation for frozen shoulder or other options suit you.
Schedule a ConsultationFrequently Asked Questions
Frozen shoulder, or adhesive capsulitis, is when the capsule around the shoulder joint becomes inflamed, thickened and tight. It causes pain and a gradual loss of movement.
Hydrodilatation is an image-guided injection of saline, often with a steroid and local anaesthetic, into the shoulder joint. The fluid stretches the tight capsule to help restore movement.
Studies suggest it can reduce pain and improve movement in the short to medium term, especially when followed by physiotherapy. Results vary between people.
It often passes through painful, stiff and thawing stages over one to three years. Treatment aims to ease pain and speed up recovery of movement.
It is most common between ages 40 and 60, more often in women, and in people with diabetes or thyroid problems, or after a period of keeping the arm still.
