Frozen Shoulder Treatment Without Surgery: Frozen Shoulder Embolization

Frozen shoulder embolization is a minimally invasive medical procedure performed by an interventional radiologist. A thin catheter is guided through the blood vessels to small vessels around the shoulder that are linked to inflammation and chronic pain. The goal is to reduce blood flow to areas of active inflammation, which may help reduce pain and improve function in suitable patients.

In persistent frozen shoulder (adhesive capsulitis), small abnormal blood vessels can develop around the joint as part of the inflammatory process. These vessels may be associated with ongoing pain, local tenderness and restricted movement. During embolization, the physician identifies the relevant vessels and blocks them selectively. The treatment is not intended to affect the normal blood supply of the shoulder. It targets the small inflammatory vessels associated with pain.

The treatment may be suitable for patients with:

• A diagnosis of frozen shoulder.
• Chronic shoulder pain.
• Significant loss of range of motion.
• Pain that disturbs sleep or daily activity.
• Insufficient improvement after physiotherapy.
• Insufficient improvement after medication or injections.
• A wish to explore an option that is not open surgery.

Suitability is determined only after a medical evaluation, a review of your medical history and imaging, and an understanding of the treatments you have already tried.

Frozen shoulder embolization is not appropriate for every type of shoulder pain. It may not be suitable when the source of pain is:

• A significant rotator cuff tear.
• A neck problem that radiates to the shoulder.
• A fracture or acute injury.
• An active infection.
• Advanced joint disease.
• A medical condition that raises the risk of a catheter-based procedure.
• A diagnosis other than frozen shoulder.

This is why the diagnostic stage matters. Before deciding on treatment, it is important to confirm that the procedure fits the patient.

The procedure takes place in an angiography suite under imaging guidance, usually with local anesthesia at the vessel access site. The procedure includes:

• Inserting a thin catheter into a blood vessel.
• Navigating the catheter to the vessels around the shoulder.
• Identifying the small inflammatory vessels.
• Injecting a controlled amount of embolic material.
• Completing the procedure and a period of observation.

The procedure does not involve opening the shoulder surgically, and it is not orthopedic surgery.

The procedure is usually performed under local anesthesia, sometimes with light sedation at the physician’s discretion. You may feel pressure or mild discomfort at the access site. Afterwards, mild local pain or tenderness at the puncture site is possible and is usually temporary.

• Treatment without open surgery.
• A minimally invasive approach.
• A procedure targeted at inflammatory vessels.
• Possible pain reduction in suitable patients.
• Possible gradual improvement in function.
• A gradual return to routine, according to instructions.
• An option when conservative treatment has not been enough.

Results are not guaranteed, and the response to treatment varies between patients.

After the procedure you remain under observation as medically required. Return to routine is usually gradual, according to the physician’s instructions and your condition. In many cases it is important to continue rehabilitation, such as physiotherapy or tailored exercise, after embolization. Less pain may allow you to exercise more effectively and gradually regain range of motion. Improvement may be gradual and is not always immediate.

As with any medical procedure, embolization carries possible risks. These may include:

• Local pain at the puncture site.
• A small bruise or hematoma.
• Temporary discomfort in the shoulder.
• A reaction to contrast material.
• Unintended effect on nearby blood vessels.
• The need for further treatment if the response is insufficient.

Before the procedure, the risks, benefits and alternatives are explained in a medical consultation.

An interventional radiologist specializes in image-guided, minimally invasive catheter procedures. In frozen shoulder, precision in identifying the small vessels associated with pain, and in embolizing them selectively, is essential. Dr. Adam Farkas, a specialist in interventional radiology, performs advanced minimally invasive treatments tailored to each patient’s condition, diagnosis and imaging findings.

An assessment usually includes:

• A review of your symptoms.
• How long the pain has lasted.
• Previous treatments.
• A review of existing imaging.
• Risk factors and background conditions.
• An explanation of the benefits, limitations and alternatives.

After that, it is possible to decide whether embolization is a suitable option or whether a different approach is needed.

Contact us to schedule a consultation with Dr. Adam Farkas and check whether frozen shoulder embolization, a minimally invasive treatment without open surgery, is right for you.

• Frozen shoulder: symptoms, stages and treatment options
• Patient guide: frozen shoulder embolization
• Book a consultation with Dr. Adam Farkas