A high-volume injection (hydrodilatation) can be extremely useful in conditions such as adhesive capsulitis (frozen shoulder). The high-volume injection is used to expand a tightened and constricted capsule which is responsible for restriction of range of movement in frozen shoulder.
This injection can result in rapid improvements in range of movement in frozen shoulder and is used when there is severe restriction. The injection usually consists of steroid, local anaesthetic and water for injection or normal saline.
Local anaesthetic is injected into the soft tissues from the skin to the joint, approaching from the back of the shoulder. After a few minutes a second needle is guided into the back of the shoulder joint under ultrasound visualisation and the steroid/local anaesthetic/water combination is injected using a 3-way tap. As the procedure is perfomed under ultrasound-guidance, the doctor can ensure that the fluid is entering the joint and effectively expanding the capsule.
The procedure takes under five minutes from start to finish and can result in a “dead arm” sensation for a short period of time. In some cases the patient will notice an immediate improvement in range of movement, when putting their clothes back on.
The patient will often notice further dramatic improvements in their pain and range of movement over the next 4-6 weeks.
High Volume Injections are also used to treat certain tendon issues such as Achilles and Patellar tendinopathy. The high volume solution is used to separate the deep part of the tendon from the underlying fat pad, which can be an effective way of reducing pain and sensitivity associated with tendinopathy, helping the individual to persevere with rehabilitation.
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