The priority during the initial (‘painful’) stage is to inject local anaesthesia and steroid into the shoulder joint. Steroid is a very effective anti-inflammatory medicine, and the steroid is injected directly into the joint using ultrasound guidance to achieve maximum pain relief.
Steroid injections are quite successful at reducing shoulder pain, especially at night (Wu at el., 2017). We frequently notice an increase in range of motion as a result of this pain reduction. Steroids, on the other hand, are mostly used to alleviate pain and inflammation. Patients might begin a physiotherapy programme once their discomfort is under control. This is critical to ensuring the patient’s complete recovery, including full range of motion and function in the shoulder.
Hydrodistension (also known as hydrodilatation or high volume injection) entails injecting the local anaesthetic and steroid as well as 20 to 30 millilitres of saline solution (sterile salty water). The purpose of this injection is to relieve discomfort while stretching the capsule to increase range of motion. This can be utilised in stage 1 of frozen shoulder, as well as on occasion in stage 2 to try to restore more movement to the joint. Following this injection, it is critical to engage in physiotherapy to regain full range of motion and strength in the shoulder.
