Traditional treatment of adhesive capsulitis with NSAIDs and physical therapy. If these fail, injection of the joint may be performed to decrease the inflammatory response. When these measures fail and symptoms persist, orthopedic surgeons may recommend “manipulation under anesthesia” which involves general anesthesia to paralyze the patient so that the orthopedist can manually manipulate the arm in range of motion to break up the fibrous tissue.
Adhesive Capsulitis Embolization, or ACE, is a relatively new minimally-invasive treatment that offers relief from the symptoms caused by frozen shoulder.
The pain caused by this condition results from overgrowth of blood vessels (neovascularization) in the lining of the shoulder joint that cause inflammatory overgrowth of fibrous tissue in the shoulder capsule. By partially blocking these abnormal vessels, the fibrous tissue rapidly regresses and symptoms improve usually within a week or two.
A specialist trained in vascular procedures known as an interventional radiologist performs the ACE procedure, and starts by making a small cut in the wrist near and inserts a thin catheter. Using x-ray guidance, they guide the catheter to the blood vessels causing the shoulder’s inflammation. Once there, small microspheres are released, and begin working to partially block or “prune” the extra blood vessels of neovascularization. Once the blood supply is properly reduced, the inflammation will begin to decrease. The catheter is then removed, pressure is applied to the wrist access with an external balloon device to prevent bleeding that is gradually deflated over the next hour and the procedure is done.
ACE is best suited for those experiencing the first or second stage of frozen shoulder, and don’t wish to wait the lengthy period it takes to reach stage three. It can take over a year before the symptoms of frozen shoulder resolve on their own, if at all.
This treatment also works best for those who don’t wish to resolve their frozen shoulder with more intensive procedures like shoulder surgery. ACE gives patients who wish to get back to normal daily activities the ability to do so quickly, without an extended recovery time.
As a minimally-invasive procedure, ACE does not necessitate a large incision, and therefore does not result in the scarring associated with surgical operations. It also carries less risk of complications and infection that comes with a treatment like shoulder surgery.
While the patient is sedated and comfortable, general anesthesia is not used, so they remain conscious for the duration of the procedure. ACE is a same-day procedure, so once the treatment is concluded you can leave the facility and recover in the comfort of your own home.
The next step is to make sure you select the best possible facility for your adhesive capsulitis embolization. It’s important to choose medical professionals who are not only highly trained, but use the latest in state-of-the-art medical technology.
The main risk with any blood vessel procedure is bleeding from the site of access. To decrease this risk, the interventional radiologist will often use a closure device in conjunction with firm pressure on the wrist access site at the conclusion of the procedure. Because the shoulder arteries also supply the skin around the shoulder, nontarget embolization of the skin is relatively common causing temporary discoloration called mottling, sometimes associated with itching, that self resolves in a week or two. The skin is highly vascular and blood reroutes quickly to return to a normal appearance. During the procedure, a cold pack is placed on the shoulder to limit microspheres going to the skin. Increased shoulder pain for a day or two is also common but also resolves within a week. Symptomatic improvement thereafter is typically rapid. Patients can return to physical therapy a few days after the procedure.
If you want to ensure that your procedure is carried out by skilled vascular specialists, you’ll want to go with Peripheral Vascular Partners.
At Peripheral Vascular Partners, we know that adhesive capsulitis of the shoulder can be a painful and debilitating condition. We make it our mission to ensure each of our patients regain healthy mobility, and experience significant relief from symptomatic pain.
Shoulder surgery is not your only option. If you don’t wish to undergo surgery, ACE can offer you relief from the symptoms of frozen shoulder without the risk and discomfort of invasive procedures. We understand you have questions, and our trained professionals have answers. Simply schedule a consultation today!
