Relief for a painful, stiff shoulder, without surgery
Shoulder embolization targets the abnormal blood vessels that drive inflammation and pain in frozen shoulder. It is done through a pinhole in the wrist, with no incision and no general anesthesia, and you go home the same day.
Call to book: 737-241-2184 How it worksWhat causes shoulder pain, and how does embolization help?
Frozen shoulder (adhesive capsulitis) happens when the capsule that surrounds the shoulder joint becomes inflamed, thickened and tight. It causes deep, aching pain, often worst at night, and a gradual loss of movement. It is more common in people aged 40 to 60 and in people with diabetes. Many cases improve slowly over one to three years, but some people are left with lasting pain and stiffness.
Research has shown that painful, inflamed tissue in frozen shoulder grows a network of tiny abnormal blood vessels. These vessels are thought to bring in inflammation and nerve fibers that cause pain.4,5
Embolization reduces blood flow through these abnormal vessels while leaving the normal blood supply to the shoulder intact. As inflammation settles, pain eases, and it becomes easier to regain movement with exercise and physical therapy.
What about shoulder osteoarthritis?
In osteoarthritis, the cartilage in the joint wears down. The same kind of abnormal blood vessels can develop in the inflamed lining of an arthritic joint, which is why embolization is also used to treat arthritis pain, most commonly in the knee (genicular artery embolization).
For the shoulder, embolization for osteoarthritis is newer and has been studied much less than for frozen shoulder. Published shoulder studies so far have focused on frozen shoulder and related tendon problems, not on shoulder arthritis.5 If arthritis is the main cause of your shoulder pain, we will review your imaging and symptoms with you and talk openly about whether embolization is reasonable to try, and what the alternatives are.
Who is a good candidate?
Shoulder embolization is usually considered after standard treatments have not worked well enough, and before surgery.5 It is often a good fit if you:
- Have frozen shoulder with pain for 3 months or more that has not improved enough with physical therapy, medication or injections.5
- Have frozen shoulder after an injury, fracture or surgery (secondary frozen shoulder).5
- Have pain that wakes you at night, which often responds well to embolization.3,4
- Want to avoid surgery or manipulation under anesthesia.
Embolization is not the right treatment for every painful shoulder. Problems such as a large rotator cuff tear, a fracture or advanced joint damage may need other treatment. Results may also be less strong in people with diabetes.3
How we decide whether embolization is right for you
We confirm the cause of your shoulder pain and make sure embolization is a sensible next step.
Consultation & exam
We review your symptoms and past treatments, and examine your shoulder's movement. You also complete a pain and function score that we use to measure your progress.
Imaging
X-rays and, when needed, MRI rule out other causes such as a large rotator cuff tear or advanced arthritis, and can show inflammation around the joint.
Treatment plan
We explain all of your options. Embolization works best when it is followed by an exercise or physical therapy program to regain movement.
How embolization compares with other options
Most people with frozen shoulder start with simple treatments. Embolization is an option when these have not been enough.
| Option | How it works | Things to know |
|---|---|---|
| Physical therapy & medication | Stretching, exercise and anti-inflammatory pain relief | The first step for everyone; recovery can take a year or more |
| Steroid injection | An anti-inflammatory steroid is injected into the joint | Can ease pain in the short term; the effect may wear off and repeat injections are limited |
| Manipulation or surgery | The shoulder is moved under anesthesia, or the tight capsule is released through keyhole surgery | Can restore movement, but needs anesthesia and a longer recovery |
| Shoulder embolization | Abnormal vessels around the joint are treated through a pinhole in the wrist | No incision, light sedation, same-day discharge; a newer treatment without randomized trials yet5 |
What happens during shoulder embolization
Shoulder embolization typically takes about an hour. You are awake but relaxed throughout.
Preparation
You receive light sedation and local anesthetic at the access site. No general anesthesia is needed.
A pinhole in the wrist
A thin tube (catheter) is placed into an artery in your wrist, or sometimes your upper thigh, through a tiny puncture. No incision is made.
Mapping the arteries
Using X-ray guidance and contrast dye, a microcatheter is steered into the small arteries around the shoulder to find the areas of abnormal blood flow.
Recovery
The catheter is removed and a small dressing applied. You rest for 30 to 60 minutes and go home the same day.
Results for frozen shoulder
Shoulder embolization has been studied in a growing number of clinical studies, and a 2022 review combined the results of 14 studies on embolization for joint pain.1
Patients whose pain was at least halved 3 months after embolization for frozen shoulder, in a study of 25 patients. Average pain fell from 7 to about 1 out of 10 by 6 months.4
Average improvement in how far patients could raise their arm forward and out to the side, across the pooled shoulder studies.1
Patients no longer needed pain medication at a median of 18 months after embolization, in a study of 20 patients.3
Night pain often improves within the first few weeks. These studies are small and did not include a comparison group, and frozen shoulder can improve on its own over time, so randomized trials are still needed to confirm how much of the benefit comes from embolization.3,5 Published results are for frozen shoulder; there are not yet published results for shoulder osteoarthritis. Individual results vary, and no treatment can guarantee success.
Risks and side effects
No major complications have been reported in published studies of shoulder embolization; side effects have been mild and temporary.1,5 We discuss all risks with you in detail beforehand:
- Temporary shoulder ache in the first days after treatment, managed with simple pain relief4
- Temporary redness or discoloration of the skin over the shoulder, which fades on its own4,5
- Bruising or tenderness at the wrist or groin puncture site4
- Rarely, temporary numbness or tingling, or swelling of the wrist or forearm3,5
- Rarely, a small clot in the wrist artery used for access2
- Reaction to contrast dye or sedation
- Pain that does not improve enough, or returns, which may need repeat treatment or another option4
Frequently asked questions
Is the procedure painful?
It is performed under local anesthesia with light sedation. Most patients feel only the small needle at the wrist. Some have a temporary ache in the shoulder for a few days.
How soon will I feel better?
Many patients notice less night pain within the first few weeks, and continue to improve over the following months.4
Do I still need physical therapy?
Yes. Embolization eases the pain so that you can work on regaining movement. Stretching and exercise afterward are an important part of recovery.
Can I use my arm afterward?
Yes. You can use your arm for everyday activities right away. If access was through the wrist, avoid heavy lifting with that hand for a few days.
Can embolization help shoulder arthritis?
Embolization is used for arthritis pain in other joints, especially the knee, but it has been studied much less for shoulder arthritis. We will discuss with you whether it is a reasonable option in your case.5
Is it covered by insurance?
Coverage varies by policy. We will navigate out-of-pocket costs with you. Call us at 737-241-2184 with questions.
Find out whether shoulder embolization is right for you
If shoulder pain and stiffness have not improved with standard treatment, an evaluation can show whether embolization is a good option.
Call 737-241-2184 to scheduleReferences
- Kim GH, Shin JH, Nam IC, et al. Transcatheter arterial embolization for benign chronic inflammatory joint pain: a systematic review and meta-analysis. J Vasc Interv Radiol. 2022;33(5):538–545. doi:10.1016/j.jvir.2022.01.013
- Sapoval M, Stacoffe N, Bertoni H, et al. Initial experience of transarterial embolization for shoulder musculoskeletal pain using an ethiodized oil-based emulsion: a multicenter study. Cardiovasc Intervent Radiol. 2025. doi:10.1007/s00270-025-04177-6
- Lanciego C, Puentes-Gutierrez A, Sanchez-Casado M, et al. Transarterial embolization for adhesive capsulitis of the shoulder: midterm outcomes on function and pain relief. J Vasc Interv Radiol. 2024;35(4):550–557. doi:10.1016/j.jvir.2023.12.572
- Liang KW, Lin HY, Hsu KL, et al. Clinical and radiological outcomes of transarterial embolization for adhesive capsulitis. Korean J Radiol. 2025;26(3):230–238. doi:10.3348/kjr.2024.0883
- Ubaldi N, Virgili F, Perconti F, et al. Transarterial embolization in the management of chronic shoulder pain: clinical evidence and emerging therapeutic role. Front Radiol. 2026;6:1753020. doi:10.3389/fradi.2026.1753020
This page provides general information and does not replace a personal medical consultation. Study results describe groups of patients and cannot predict the outcome for an individual. Urology Austin and IR Centers · 8701 N. Mopac, Suite 100, Austin, Texas 78759 · 737-241-2184