Shoulder pain is common
At North Star Vascular & Interventional, we see many patients who experience chronic shoulder pain that limits motion, sleep, and daily activities. Two of the most common causes are frozen shoulder (adhesive capsulitis) and chronic rotator cuff tendinitis.
While both conditions affect the shoulder joint, they have different underlying causes — and both can now be treated with a non-surgical, image-guided procedure called shoulder embolization.
What is Frozen Shoulder (Adhesive Capsulitis)?
Frozen shoulder occurs when the tissue surrounding the shoulder joint, called the capsule, becomes inflamed and thickened. This inflammation leads to scar tissue (adhesions), making the shoulder “stick” and limiting movement.
Symptoms
- Gradual onset of shoulder stiffness
- Deep, aching pain (often worse at night)
- Restricted range of motion
- Pain when reaching overhead or behind the back
Causes
- Inflammation within the shoulder capsule
- Post-surgery or injury immobilization
- Diabetes or thyroid disorders (increased risk)
- Sometimes, no clear cause at all
The frozen shoulder joint becomes highly vascularized — meaning new, abnormal blood vessels form in the capsule. These vessels carry inflammatory mediators that worsen pain and stiffness over time.
What is Chronic Rotator Cuff Tendinitis?
The rotator cuff is a group of tendons that help lift and stabilize the shoulder. With chronic overuse, injury, or age-related wear, these tendons can become inflamed or degenerated, causing tendinitis that fails to heal properly.
Symptoms
- Shoulder pain that worsens with activity or lifting
- Weakness when raising the arm
- Nighttime pain or difficulty sleeping on the affected side
- Tenderness in the front or side of the shoulder
Causes
- Repetitive overhead activity or strain
- Poor posture or muscle imbalance
- Aging or reduced blood flow to the tendon
- Unresolved acute injury
In chronic cases, abnormal blood vessels grow around the damaged tendon, fueling inflammation and preventing recovery — similar to what occurs in frozen shoulder.
When Conservative Treatments Aren’t Enough
Typical care may include:
- Physical therapy
- Anti-inflammatory medications
- Corticosteroid injections
- Rest and modified activity
While these can help temporarily, they often fail to stop inflammation at its source. When symptoms persist for months despite these efforts, minimally invasive embolization may provide lasting relief.