📖 What is adhesive capsulitis (frozen shoulder)?
Adhesive capsulitis, commonly known as frozen shoulder, is an inflammation and contraction of the shoulder joint capsule, causing severe pain and a progressive loss of mobility in all directions. It affects about 2 to 5% of the population, more often women aged 40 to 60, people with diabetes, and after trauma or prolonged immobilisation.
Percutaneous arterial embolization targets the pathological neovascularisation of the joint capsule, which sustains the inflammation. It is performed under local anaesthesia, on an outpatient basis, under angiographic guidance — with pain reduction in 70 to 80% of cases at 6 months. It can be offered alongside physiotherapy.
What are the expected benefits?
- Pain reduction in 70 to 80% of cases at 6 months
- Outpatient treatment under local anaesthesia, without hospital admission
- No immobilisation required, compatible with ongoing physiotherapy
- Repeatable technique in case of partial recurrence
How does it work?
Prior work-up: shoulder MRI or Doppler ultrasound documenting the capsular neovascularisation.
Local anaesthesia, radial or femoral arterial access.
Hyperselective catheterisation of the arteries feeding the joint capsule (branches of the humeral circumflex, suprascapular and thoracoacromial arteries) and injection of calibrated microspheres.
Duration: 45 to 90 minutes. Monitoring for 2 to 4 hours, then discharge home.
What happens afterwards?
Expected and transient effects:
- Mild pain at the puncture site and in the shoulder for 24 to 48h, treated with simple analgesics
- No immobilisation, light activities resumed the next day
- Progressive improvement over 4 to 12 weeks
The complications are as follows:
| Complication | Description | Frequency |
|---|---|---|
| Haematoma at the puncture site | Spontaneous resolution | < 3 % |
| No improvement | Discussion of alternatives (injection, surgery) | 20–30 % |
What are the limits of the treatment?
Pain improvement is progressive (4 to 12 weeks) and physiotherapy must be continued. In 20 to 30% of cases, improvement is insufficient and other options may be discussed.
What other techniques and alternatives are possible?
💉 Injections / capsular distension
Corticosteroid injection or capsular distension (hydrodilatation), often as first-line treatment.
🔨 Physiotherapy
Essential, to be continued before and after embolization.
🏥 Surgery / arthrolysis
Surgical capsular release under general anaesthesia, reserved for failure of other treatments.
👁️ Watchful waiting
Frozen shoulder can resolve spontaneously over 1 to 3 years in some cases.
What if I decide not to have the treatment?
You remain entirely free in your decision. Your doctor will discuss the alternatives with you: injections, physiotherapy, surgery, or monitoring depending on your situation.
❓ Frequently asked questions
Book an appointment at Cochin AP-HP
Hôpital Cochin · 27 rue du Faubourg Saint-Jacques · 75014 Paris · No extra fees