Frozen Shoulder Embolization: Patient Information

Frozen shoulder embolization is an advanced, minimally invasive treatment performed through a catheter. The aim of the treatment is to reduce blood flow to small blood vessels around the shoulder that are linked to an inflammatory process and to chronic pain. The treatment is intended mainly for patients whose frozen shoulder has not improved enough after conservative treatment. It is not open surgery, and it does not involve opening the shoulder joint.

In some cases of frozen shoulder and chronic shoulder pain, small abnormal blood vessels form around the shoulder as part of the inflammatory process. These vessels may be linked to ongoing pain and local tenderness. During embolization, the doctor identifies the relevant blood vessels and blocks them in a targeted way. The aim of the blockage is to reduce local inflammation and pain, and to allow a more effective rehabilitation process. This treatment rationale has also been described in the medical literature on frozen shoulder embolization.

The treatment may be suitable for patients with:

• A diagnosis of frozen shoulder.
• Chronic shoulder pain.
• Restricted movement.
• Pain that interferes with sleep or function.
• Insufficient improvement after physiotherapy, medication or injections.
• A wish to avoid surgery, when a suitable treatment option exists.

Suitability is determined after a medical consultation, a review of previous tests and, in some cases, additional imaging.

The treatment may not be suitable when:

• The source of the pain is not frozen shoulder.
• There is a significant tear in the shoulder tendons that requires a different treatment.
• There is an active infection.
• There is a medical problem that raises the risk of a catheter-based procedure.
• The doctor’s assessment finds no anatomical or clinical suitability.

This is why an accurate diagnosis matters, rather than relying on a general sense of “shoulder pain”.

Possible advantages of frozen shoulder embolization:

• Treatment without open surgery.
• A very small incision or a needle puncture only.
• A procedure targeted at the inflammatory blood vessels.
• A possible reduction in pain in suitable patients.
• An option for cases in which conservative treatment was not enough.
• A gradual return to routine, according to the doctor’s instructions.

The treatment may help reduce pain and improve function in suitable patients.

The procedure takes place in an angiography suite. After local anesthesia, a thin catheter is inserted into a blood vessel, usually through the groin or the arm, at the doctor’s discretion. Under X-ray guidance, the catheter is navigated to the blood vessels that supply the inflamed area of the shoulder. Once the relevant vessels have been identified, a controlled amount of embolic material is injected to reduce blood flow to the inflamed area.

After the procedure, the patient stays for observation. In most cases the return to routine is gradual, according to the doctor’s instructions. Sometimes it is recommended to continue physiotherapy after the treatment, to improve range of motion and strengthen function. The improvement in pain may be gradual and is not always immediate. It is important to attend follow-up and to follow the instructions given after the procedure.

An interventional radiologist is a doctor who specializes in image-guided, catheter-based treatments. In the treatment of frozen shoulder, precision in identifying the small blood vessels and in performing a targeted embolization is a central part of the procedure. Dr. Adam Farkas performs advanced minimally invasive treatments for blood vessels and pain, tailoring the treatment to the patient’s medical condition and imaging findings.

If you have frozen shoulder, chronic shoulder pain or restricted movement that has not improved enough, you can schedule a consultation to find out whether frozen shoulder embolization may be suitable for you.

• Frozen shoulder embolization: the catheter-based treatment, without surgery
• Frozen shoulder: symptoms, stages and treatment options
• Book a consultation with Dr. Adam Farkas