Frozen Shoulder Treatment in San Antonio, TX
Minimally Invasive Relief for Frozen Shoulder Pain & Stiffness
Frozen shoulder can make ordinary movements unexpectedly difficult. Reaching into a cabinet, putting on a shirt, fastening a seat belt, sleeping comfortably, or lifting your arm overhead may become painful as the shoulder gradually loses movement.
Frozen shoulder, also called adhesive capsulitis, occurs when the capsule surrounding the shoulder joint becomes inflamed, thickened, and tight. For many people, physical therapy, medication, and injections provide enough improvement. For others, pain and restricted movement continue despite months of conservative treatment.
At Ally Vascular & Pain Centers in San Antonio, our interventional radiologists offer a minimally invasive treatment called adhesive capsulitis embolization, also known as shoulder embolization or transarterial embolization.
The procedure targets abnormal blood vessels associated with persistent inflammation around the shoulder. It is performed through a small catheter rather than a surgical incision and may be considered for selected patients whose frozen shoulder has not responded adequately to conventional treatment.
What Is Frozen Shoulder?
Frozen shoulder is a condition that causes progressive shoulder pain, stiffness, and loss of range of motion.
The shoulder joint is surrounded by a flexible capsule of connective tissue. With adhesive capsulitis, this capsule becomes inflamed and gradually thickens and tightens. The result is less space for the shoulder to move comfortably.
Unlike many other shoulder conditions, frozen shoulder typically restricts both active movement, when you move the arm yourself, and passive movement, when someone else attempts to move your arm.
The Mayo Clinic overview of frozen shoulder explains that symptoms often develop slowly and can persist for an extended period.
Frozen shoulder commonly progresses through three stages:
Freezing Stage
Pain gradually increases and shoulder movement becomes more limited. Nighttime pain can become especially disruptive.
Frozen Stage
Pain may begin to decrease, but stiffness can become more pronounced. Reaching overhead, behind the back, or across the body may be difficult.
Thawing Stage
Movement gradually begins to return as the shoulder capsule loosens.
The entire process can take months or even years, although the course varies considerably between patients.
Common Symptoms of Frozen Shoulder
Shoulder Pain
Persistent aching or pain around the shoulder that may worsen with movement.
Nighttime Pain
Shoulder discomfort that makes it difficult to sleep comfortably or lie on the affected side.
Limited Overhead Reach
Difficulty raising the arm to reach shelves, cabinets, or objects above shoulder height.
Difficulty Reaching Behind Your Back
Activities such as dressing, fastening clothing, or reaching into a back pocket can become difficult.
Progressive Shoulder Stiffness
The joint may feel increasingly tight even when pain begins to improve.
Reduced Range of Motion
Both active and passive shoulder movement can become restricted.
These symptoms can overlap with rotator cuff injuries, arthritis, tendon problems, and other causes of shoulder pain. A proper evaluation is important before deciding on treatment.
What Causes Frozen Shoulder?
The exact cause is not always clear.
Frozen shoulder may develop without an obvious injury, but certain health conditions and periods of prolonged shoulder immobility can increase the risk.
- Age between approximately 40 and 60
- Diabetes
- Thyroid disorders
- Previous shoulder injury
- Shoulder surgery
- Keeping the arm immobilized after an injury or procedure
- Certain systemic health conditions
The inflammatory process also appears to play an important role.
As the shoulder capsule becomes inflamed, abnormal small blood vessels may develop around affected tissues. This increased vascularity is one of the targets of adhesive capsulitis embolization.
How Is Frozen Shoulder Diagnosed?
- Frozen shoulder is usually diagnosed through a combination of medical history and physical examination.
- Your physician will ask how the symptoms started, how long they have been present, which movements are limited, and what treatments have already been attempted.
- Range of motion is particularly important.
- Frozen shoulder tends to restrict both the movement you can produce yourself and the amount of movement the examiner can produce when your arm is relaxed.
- Imaging may also be used to rule out other conditions.
- According to the Mayo Clinic frozen shoulder diagnosis guide, X-rays, ultrasound, or MRI may sometimes be used when another shoulder problem needs to be excluded.
At Ally Vascular & Pain Centers, evaluation also helps determine whether persistent inflammation is likely to be contributing to the pain and whether an image-guided procedure is appropriate.
What Are the Treatment Options for Frozen Shoulder?
Treatment depends on the stage of frozen shoulder, symptom severity, and which therapies have already been tried. Common options include:
- Physical therapy and range-of-motion exercises
- Anti-inflammatory or pain medication
- Corticosteroid injections
- Hydrodilatation
- Adhesive capsulitis embolization
- Manipulation or arthroscopic surgery in selected cases
Adhesive Capsulitis Embolization
Adhesive capsulitis embolization is a minimally invasive, image-guided procedure for selected patients with persistent frozen shoulder pain and stiffness.
Frozen shoulder is associated with inflammation around the shoulder capsule. In some patients, abnormal small blood vessels develop around these inflamed tissues. Embolization works by reducing blood flow through selected vessels associated with the inflammatory process.
The procedure is performed in an outpatient setting through a small arterial access point. Using real-time imaging, an interventional radiologist guides a catheter toward the vessels supplying the affected area and delivers embolic material to reduce abnormal blood flow.
Benefits of Adhesive Capsulitis Embolization
- Minimally invasive treatment without shoulder surgery
- Outpatient procedure with limited downtime
- Targets blood vessels associated with persistent inflammation
- Preserves the natural shoulder joint
- May help reduce pain and improve shoulder mobility
Who May Adhesive Capsulitis Embolization Be A Fitting Treatment For?
- Patients that have persistent pain and stiffness from frozen shoulder.
- Patients that have limited active and passive shoulder movement.
- Patients that have not improved enough with physical therapy, medication, or injections.
- Patients that have symptoms that interfere with sleep or daily activities.
- Patients that want to explore a minimally invasive option before surgery.
For patients in San Antonio whose frozen shoulder symptoms continue despite conservative treatment, adhesive capsulitis embolization may provide another option for addressing persistent inflammation and pain.
Potential Benefits of Frozen Shoulder Embolization
Minimally Invasive
Treatment is performed through a small arterial access point rather than an incision in the shoulder.
Targets Inflammation
Embolization focuses on abnormal blood vessels associated with the inflammatory process around the shoulder capsule.
Outpatient Procedure
Patients generally return home after a period of observation rather than staying overnight in a hospital.
Preserves the Shoulder Joint
No bone, tendon, or joint surface is removed or replaced during embolization.
Limited Downtime
Recovery is generally much shorter than recovery following shoulder surgery, although individual activity instructions vary.
How Does Adhesive Capsulitis Embolization Work?
Adhesive capsulitis embolization is an image-guided procedure performed by an interventional radiologist.
Research into frozen shoulder has identified abnormal vascularity, or increased growth and activity of small blood vessels, in areas affected by persistent inflammation.
During treatment, the physician makes a small arterial access point, commonly near the wrist. A thin catheter is then guided through the blood vessels using real-time X-ray imaging.
Contrast material allows the interventional radiologist to identify abnormal blood flow around the shoulder.
Once the appropriate vessels have been identified, very small embolic material is delivered through the catheter to reduce blood flow to the targeted inflammatory tissue.
The goal is to interrupt part of the inflammatory process contributing to persistent pain.
A study published in the Journal of Vascular of Interventional Radiology of transarterial embolization for refractory adhesive capsulitis and related shoulder conditions reported improvements in pain, shoulder movement, and functional scores following treatment. The investigators also noted that existing studies remain heterogeneous and that additional randomized evidence is needed.
Comparing Frozen Shoulder Treatment Options
Feature
Physical Therapy
Steroid Injection
Shoulder Embolization
Surgery
Approach
Guided exercises and mobility work
Medication injected into the joint
Image-guided catheter procedure
Surgical or manipulation-based treatment
Primary Goal
Restore movement
Reduce pain and inflammation
Reduce abnormal inflammatory blood flow
Release severe capsular restriction
Surgical Incision
No
No
No shoulder incision
Usually yes for arthroscopy
Typical Setting
Outpatient
Office/outpatient
Outpatient
Surgical facility
Recovery
Minimal
Minimal
Generally limited
Longer
Often Considered
Common first-line treatment
Persistent pain/inflammation
Symptoms refractory to conservative care
Severe refractory cases
The appropriate treatment depends on the stage of frozen shoulder, symptom severity, previous treatment, health history, and the actual source of shoulder pain.
Embolization is not intended to replace physical therapy for every patient or to eliminate the need for surgery in every severe case. It is another treatment option for selected patients whose symptoms remain difficult to control.
Who May Be a Candidate for Frozen Shoulder Embolization?
Adhesive capsulitis embolization is generally considered for patients with persistent frozen shoulder symptoms that have not improved enough with conservative treatment.
- A diagnosis of adhesive capsulitis
- Persistent shoulder pain and stiffness
- Restricted active and passive range of motion
- Symptoms that interfere with sleep, work, dressing, exercise, or daily activities
- Limited improvement after physical therapy or other conservative treatment
- Persistent inflammation-related symptoms
- A desire to explore an option before surgical treatment
Published reviews of shoulder embolization have primarily evaluated patients with refractory adhesive capsulitis, meaning symptoms continued despite conventional management.
Not everyone with shoulder pain is a candidate.
Rotator cuff tears, significant arthritis, fractures, nerve problems, infection, or other conditions may require a different treatment approach.
What to Expect at Your Frozen Shoulder Consultation
Comprehensive Evaluation
We review your shoulder symptoms, medical history, how long the stiffness has been present, and which treatments you have already tried.
Imaging and Candidacy Review
Available shoulder imaging is reviewed to help rule out other causes of pain and determine whether additional imaging is needed.
Personalized Treatment Plan
Your treatment plan is based on the cause of your symptoms, stage of frozen shoulder, previous treatment, imaging findings, and individual goals.
What Happens During Shoulder Embolization?
The procedure is performed using real-time medical imaging.
- 1. The arterial access area is cleaned and numbed with local anesthetic.
- 2. A small catheter is introduced into an artery, commonly through the wrist.
- 3. The catheter is guided toward arteries supplying the affected shoulder.
- 4. Contrast imaging helps identify areas of abnormal blood flow.
- 5. Selected vessels are treated with embolic material.
- 6. The catheter is removed and the access area is dressed.
- 7. You are monitored before returning home.
Procedure details vary according to anatomy and imaging findings.
What Is Recovery Like After Frozen Shoulder Embolization?
Shoulder embolization does not require a large surgical incision, so recovery is generally limited compared with surgical treatment.
Patients typically return home following observation.
Some temporary soreness or bruising may occur around the arterial access site. Your physician will provide instructions regarding lifting, exercise, medications, and return to normal activity.
Improvement is not always immediate.
Published studies of adhesive capsulitis embolization have reported changes in pain and shoulder mobility over the weeks and months following treatment.
Physical therapy or an appropriate range-of-motion program may still be part of recovery. Reducing pain can make rehabilitation easier, but restoring shoulder movement usually remains an important part of frozen shoulder management.
Why Choose Ally Vascular & Pain Centers for Frozen Shoulder Treatment in San Antonio?
Persistent frozen shoulder can be frustrating, especially when months of treatment have not restored comfortable movement.
At Ally Vascular & Pain Centers, our focus is on precise, minimally invasive treatments for chronic pain and vascular conditions.
Advanced Image-Guided Precision
Our board-certified interventional radiologists use real-time imaging to navigate small blood vessels and deliver treatment to targeted areas while minimizing disruption to surrounding tissue.
Experience With Musculoskeletal Embolization
Dr. Sandeep Rao has more than 20 years of experience in interventional radiology and has performed musculoskeletal embolization procedures for painful joints since 2020. Learn more about our interventional radiologists.
Outpatient, Patient-Focused Care
Procedures are performed in an outpatient setting in San Antonio, helping patients avoid hospital admission and lengthy surgical recovery when a minimally invasive treatment is appropriate.
Patients searching for frozen shoulder treatment in San Antonio can visit Ally Vascular & Pain Centers at 600 E. Amber St. #107.
Our Simple Process
1. Get in Touch
Contact our San Antonio clinic to schedule a consultation and tell us about your shoulder pain, stiffness, and previous treatment.
2. Personalized Evaluation
Meet with one of our physicians for an evaluation, imaging review, and discussion of whether conservative care, embolization, or another treatment may be appropriate.
3. Procedure and Recovery
If embolization is recommended, treatment is performed in an outpatient setting using precise image-guided techniques followed by individualized recovery instructions.
Take the First Step Toward Moving Your Shoulder Again
Frozen shoulder can make basic activities such as getting dressed, reaching overhead, driving, exercising, and sleeping comfortably much harder than they should be.
If physical therapy, medication, injections, or time have not provided enough relief, another option may be worth discussing.
At Ally Vascular & Pain Centers, our interventional radiologists offer minimally invasive frozen shoulder embolization for appropriately selected patients in San Antonio and surrounding South Texas communities.
Call (210) 660-5040 or schedule a consultation to find out whether adhesive capsulitis embolization may be an option for you.
Frequently Asked Questions About Frozen Shoulder Treatment
Can frozen shoulder go away without treatment?
Frozen shoulder can gradually improve over time, but recovery may take many months and sometimes longer. Treatment is generally focused on managing pain and maintaining or restoring shoulder movement while the condition progresses.
When should I see a specialist for frozen shoulder?
Consider an evaluation when shoulder pain and stiffness continue to worsen, interfere with sleep or daily activities, or do not improve with conservative care. It is also important to confirm that another shoulder condition is not causing the symptoms.
Is shoulder embolization surgery?
No. Adhesive capsulitis embolization is a minimally invasive endovascular procedure. A small catheter is guided through an artery to vessels around the shoulder. No surgical incision is made into the shoulder joint.
Does shoulder embolization replace physical therapy?
Not necessarily. Physical therapy and range-of-motion exercises remain important parts of frozen shoulder treatment. Embolization may be considered when persistent inflammation and pain limit progress despite appropriate conservative treatment.
How quickly can frozen shoulder improve after embolization?
Improvement varies. Published studies have reported reductions in pain and improvements in range of motion during the weeks and months after treatment, but individual response cannot be guaranteed.
Can frozen shoulder come back?
Recurrence in the same shoulder is uncommon after the condition resolves, although frozen shoulder can later develop in the opposite shoulder.
Is frozen shoulder embolization safe?
Published studies have generally reported a favorable safety profile, with most reported adverse events being mild or moderate. However, embolization remains a medical procedure with potential risks related to arterial access, contrast material, and unintended embolization. Your physician will review these risks before treatment.
Where can I get frozen shoulder treatment in San Antonio?
Ally Vascular & Pain Centers provides evaluation and minimally invasive treatment for frozen shoulder at 600 E. Amber St. #107 in San Antonio, Texas. Patients can call (210) 660-5040 to schedule an evaluation.
