Frozen Shoulder / Adhesive Capsulitis: TAME, Capsular Hydrodilatation, and Nerve Hydrodissection — Case Report

Author: Bow Wang, M.D.

Ms. K, 59 years old, had been experiencing right shoulder pain for nine months. Raising her shoulder forward or backward to a certain angle caused pain, making even fastening her bra difficult. After seeking medical attention, she was diagnosed with adhesive capsulitis of the shoulder, commonly known as "frozen shoulder," also called "adhesive capsulitis" or "adhesive capsulitis." Despite undergoing various traditional treatments, the pain persisted without significant improvement. Ms. K was in so much pain that she could not raise her arm, lift heavy objects, or even sleep soundly at night when turning over and pressing on the affected side, severely impacting her quality of life.

After traditional treatments proved ineffective, Ms. K sought treatment at National Cheng Kung University Hospital Orthopedics Clinic. She was then referred by Director Su Weiren to the Interventional Medical Center at Bow Wang, M.D. for further discussion. Following the discussion, Bow Wang, M.D. performed the Transarterial Microembolization (TAME) procedure on Ms. K. Guided by X-ray fluoroscopy and under local anesthesia, a microcatheter was inserted through the radial artery in her wrist to locate the painful area in her shoulder. Under arterial angiography, contrast agent was injected to identify newly formed capillary-like vessels in the shoulder joint capsule. Embolizing medication was then injected through the microcatheter to remove these abnormal capillary-like vessels.

With embolization therapy combined with rehabilitation, Ms. K's pain and range of motion improved by 70%. Bow Wang, M.D. then performed a shoulder joint capsule expansion and a nerve adhesion release procedure on Ms. K.

After the treatment, Ms. K's pain and range of motion improved further. She no longer experienced sleeplessness or woke up at night due to severe pain, and her quality of life significantly improved.

The application of Transarterial Microembolization (TAME) in "adhesive capsulitis/frozen shoulder" also has limitations. The main indications are severe pain/a pain index exceeding 5 points, and patients who have received various treatments for more than three months without significant improvement. If the patient has passed the period of severe pain and the main concern is limited range of motion, more effective treatments are shoulder joint capsule dilation and nerve adhesion release.