Shoulder pain can arise from various causes and sometimes be accompanied by restricted movement. If the pain persists for more than three months and is unresponsive to medication, angioplasty embolization treatment may be considered. This treatment works by reducing blood flow to the painful area in the shoulder and cutting off the nourishment to the nerves.
The treatment typically starts showing effects within a week and reaches its maximum effectiveness in one to four months. Furthermore, this method provides a pain-free life for years without damaging the shoulder joint or cartilage. The procedure is performed while the patient is awake on the angiography table, and the patient is discharged in a short time.
| Treatment Method | Angioembolization |
| Applications | Used in shoulder pain, especially in cases where pain and inflammation arise from blood vessels in the shoulder joint |
| Indications | Anomalies of blood vessels in the shoulder, pain from blood vessels, muscle tears, rotator cuff injuries |
| Procedure Description | A catheter is inserted into the blood vessel, and the targeted blood vessel is blocked to stop blood flow |
| Advantages | It is a minimally invasive method, does not require general anesthesia, quick recovery process, short hospital stay |
| Complications | Infection, bleeding, allergic reactions, tissue damage after embolization |
| Success Rate | It has a high success rate and provides effective results when applied with the correct indications |
| Recovery Process | A few days of rest after the procedure, pain management with medication, physical therapy may be recommended |
| Alternative Treatments | Physical therapy, surgical intervention, steroid injections, painkillers, and anti-inflammatory drugs |
| Preparation and Precautions | Discontinuing blood-thinning medications before the procedure, using local anesthesia during the procedure, avoiding certain activities post-procedure |
| Epidemiology | A less common method for treating shoulder pain, used in patients with specific vascular problems |
Prof. Dr. Özgür KILIÇKESMEZ
Interventional Radiology / Interventional Neuroradiology
Possible Causes of Shoulder Pain
Shoulder pain can originate from a problem in the shoulder joint or from discomfort in other areas of the body. It is commonly seen in individuals who work with heavy lifting. Various conditions contribute to shoulder pain, including:
- Blows to the shoulder
- Frozen shoulder syndrome
- Shoulder dislocation
- Shoulder impingement
- Excessive load on the shoulder
- Fractures or cracks in the arm
- Clavicle fracture
Additionally, serious health issues such as heart attacks and lung diseases can cause shoulder pain. Joint diseases and spinal injuries are other causes of this pain. Sleeping continuously on one side or performing improper movements during sports can also lead to shoulder pain. Accurate diagnosis and treatment methods are important to identify the source of shoulder pain.
What is Angioembolization?
Angioembolization is a minimally invasive interventional radiology technique that has been frequently used in pain treatments in recent years. In this method, a catheter is used to access problematic vessels and block them with special medical materials. The goal is to stop abnormal blood flow in the targeted area, thereby reducing pain.
Key features of angioembolization include:
- It is minimally invasive, requiring minimal intervention on the body.
- It is usually performed under local anesthesia.
- The patient does not feel pain during the procedure.
- The procedure is monitored using radiological imaging methods.
This method carries fewer risks compared to traditional surgery and offers a faster recovery process. In addition to shoulder pain, it is an effective treatment option for various conditions such as cancer treatment, gynecological diseases, and post-trauma bleeding.
When is Angioembolization Used?
Angioembolization is an effective treatment option for specific conditions causing shoulder pain. It is especially used in cases of chronic pain unresponsive to other treatments. This treatment method can also be successful in cases of pain caused by shoulder joint calcification.
Moreover, it may be effective for pain caused by benign or malignant tumors in the shoulder area. In these cases, angioembolization blocks the blood vessels feeding the tumor, alleviating pain. Finally, it can also be applied for pain caused by shoulder trauma and can speed up the recovery process. Angioembolization can be used in the following conditions:
- Chronic Shoulder Pain: Pain that is long-lasting and unresponsive to other treatments.
- Osteoarthritis (Calcification): Pain caused by calcification in the joint.
- Painful Tumors: Pain caused by benign or malignant tumors.
- Post-Trauma Pain: Pain due to shoulder trauma.
Angioembolization Procedure Process
- Shoulder pain embolization before and after image
To ensure the patient is comfortable, local anesthesia and a mild sedative are administered. The area to be treated is carefully cleaned and disinfected. During the procedure, vital signs, especially heart rate and blood pressure, are closely monitored.
Catheter Placement:
- A small incision is usually made in the groin area to access a large blood vessel.
- A thin and flexible tube (catheter) is inserted into the blood vessel and guided to the targeted blood vessel using real-time X-ray imaging (fluoroscopy).
Angiography:
- Contrast dye is injected from the catheter to visualize the blood vessels in X-ray images.
- This helps the interventional radiologist locate the exact blood vessel to be embolized.
Embolization:
- Various embolic agents, such as small particles, are delivered through the catheter to the targeted blood vessel.
- The selection of the embolic agent depends on the treated condition and the desired outcome.
- These agents block or significantly reduce blood flow to the targeted area.
Completion and Recovery:
- After embolization, the catheter is carefully removed, and the needle entry site is bandaged.
- Patients are generally monitored for a few hours to ensure no complications.
- Most patients are discharged on the same day and can return to their normal activities within a few days.
All these steps are followed carefully to ensure the angioembolization procedure is performed safely and effectively.
Benefits of Angioembolization in Shoulder Pain
Angioembolization offers significant advantages in treating shoulder pain. The procedure stands out for being minimally invasive, as it does not require large incisions and is performed with just a small needle puncture. This results in a faster and more comfortable recovery process. Additionally, patients can generally return to normal activities shortly after the procedure, supporting a quick recovery.
- Minimally Invasive: The procedure is performed with minimal body intervention, using only a small needle puncture. This makes the recovery process faster and more comfortable.
- Quick Recovery: Patients typically return to normal activities shortly after the procedure.
- Effective Pain Control: Angioembolization provides effective and long-lasting pain relief in shoulder pain cases.
- Alternative Treatment Option: It offers a promising alternative when other treatment methods are insufficient.
In conclusion, angioembolization provides an effective, fast, and minimally invasive treatment method for shoulder pain.
Post-Treatment Recovery Process
First Few Hours Post-Procedure:
- Rest: You will be monitored in the recovery room for several hours. The primary focus is to ensure no bleeding from the catheter entry site and to observe for any emergency complications.
- Bed Rest: Depending on the procedure and the embolized area, you may need to rest in bed for several hours to a day. This helps prevent bleeding and allows the embolic material to stabilize.
- Pain Management: You may feel mild discomfort or pain at the catheter entry site. Pain relievers will be provided if necessary.
- Diet: You may continue a normal diet as tolerated. However, it is important to drink plenty of fluids to help flush the contrast dye from your system.
First Few Days:
- Home Recovery: Most patients are discharged on the same day or the next day.
- Gradual Return to Activities: It is important to gradually return to normal activities based on your doctor’s advice. Avoid strenuous activities and heavy lifting for a few days.
- Monitoring for Complications: Watch for signs of complications, such as fever, increased pain, swelling, redness, or drainage at the catheter entry site. Report any concerns to your doctor immediately.
Following Weeks:
- Follow-up Appointment: You will have a follow-up appointment with your doctor to confirm the success of the embolization and assess your progress.
- Continued Recovery: The embolized area will continue to heal, and symptoms related to the original condition should gradually improve.
- Medication and Lifestyle Changes: Medications may be prescribed to manage any underlying conditions or prevent complications. Lifestyle changes such as diet and exercise may also be recommended to support overall health and prevent future issues.
Long Term:
- Regular Check-ups: It is important to continue with regular check-ups as recommended by your doctor to monitor your health and detect potential issues early.
- Healthy Lifestyle: Maintaining a balanced diet, regular exercise, and stress management will contribute to long-term health.
Potential Risks and Side Effects of Angioembolization Treatment
Like any medical procedure, there are potential risks and side effects associated with angioembolization treatment. While these risks are generally low, they must be carefully evaluated for each patient. When performed by an experienced team, the risk of complications is significantly reduced. Possible risks and side effects during the procedure include:
- Bleeding or infection at the catheter entry site
- Allergic reaction to the contrast dye
- Damage to blood vessels or surrounding organs
- Blood clots
- Movement of embolic material to unwanted areas
These potential risks can be minimized with careful pre-evaluation and appropriate treatment protocols, ensuring patient safety.
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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