What is musculoskeletal embolization?

Musculoskeletal embolization — also called transarterial embolization (TAE) or transcatheter arterial micro-embolization — is a minimally invasive, catheter-based treatment for chronic joint and tendon pain. In conditions like frozen shoulder, tennis elbow, and plantar fasciitis, abnormal new blood vessels grow into the inflamed tissue alongside new nerve fibers. Dr. Fischman guides a tiny catheter to the small arteries feeding that tissue and injects an embolic agent to reduce the abnormal vessels, which can calm inflammation and pain without surgery.

Is this the same as genicular artery embolization (GAE)?

It is the same concept applied to different joints. Genicular artery embolization (GAE) refers specifically to the knee, because the genicular arteries supply the knee. For the shoulder, elbow, hand, hip, heel, and Achilles tendon, different arteries are treated, so the procedure is usually called musculoskeletal or transarterial embolization.

Which conditions does Dr. Fischman treat with musculoskeletal embolization?

Dr. Fischman treats frozen shoulder (adhesive capsulitis), rotator cuff tendinopathy and shoulder impingement, tennis elbow and golfer's elbow, thumb-base and finger osteoarthritis, hip osteoarthritis and greater trochanteric pain syndrome, plantar fasciitis, and Achilles tendinopathy. Knee osteoarthritis is treated with genicular artery embolization.

Where does the catheter go in?

It depends on the joint. For the shoulder and elbow, Dr. Fischman typically works through the wrist (radial artery). For the hand, foot, heel, and Achilles tendon, access is typically through the groin (femoral artery). For the hip, access may be through the groin, the wrist, or the foot, depending on your anatomy. The puncture is about the size of a pencil tip and does not require stitches.

What embolic agent is used?

Depending on the condition and the anatomy, Dr. Fischman uses either a temporary (resorbable) or a permanent embolic agent. The goal is to reduce the abnormal vessels feeding the inflamed tissue while preserving normal blood supply to the joint, tendon, and skin.

How soon will I feel better, and how long does it last?

Many patients notice improvement within the first few weeks, and relief often continues to build over one to three months. In published studies, improvement has generally been maintained at one to two years for frozen shoulder, tennis elbow, plantar fasciitis, and Achilles tendinopathy, though results vary by condition and by patient. The procedure can be repeated if symptoms return.

Serious complications are uncommon in published series. The most common side effects are temporary soreness at the treated area and temporary skin discoloration over the treated region, which usually resolves on its own. As with any catheter procedure, there is a small risk of bruising at the access site. Dr. Fischman reviews the specific risks for your condition during your consultation.

Is musculoskeletal embolization covered by insurance?

Insurance coverage varies. Many insurers still consider embolization for these conditions investigational, while others review it case by case. Coverage depends on your plan, your diagnosis, and your prior treatments. Dr. Fischman's office will review your benefits and pursue prior authorization where possible, and will discuss any out-of-pocket cost with you before the procedure is scheduled.

You may be a candidate if you have had pain for at least three months that has not improved with physical therapy, activity modification, anti-inflammatory medications, bracing or orthotics, or injections. An MRI or ultrasound showing inflammation helps confirm that the pain is coming from the target joint or tendon. Dr. Fischman reviews your imaging and history to decide whether embolization is appropriate — or whether another treatment would serve you better.

Musculoskeletal Embolization NYC | Frozen Shoulder, Tennis Elbow, Plantar Fasciitis

Treatment site	Typical access
Shoulder	Wrist (radial artery)
Elbow	Wrist (radial artery)
Hand & thumb	Groin (femoral artery)
Hip	Groin, wrist, or foot — based on anatomy
Heel & Achilles	Groin (femoral artery)
Knee (GAE)	Foot first, then groin or wrist

Conditions Treated

Conditions Dr. Fischman Treats
with Musculoskeletal Embolization

Each condition below lists the usual access site, the strength of the published evidence, and representative results from peer-reviewed studies. Numbers are drawn directly from the cited papers; individual results vary.

Shoulder

Frozen Shoulder & Rotator Cuff Pain

Access: Wrist (radial artery) Evidence: Meta-analysis + prospective series

Frozen shoulder (adhesive capsulitis) is the condition with the most published data outside the knee. The joint capsule becomes inflamed and thickened, and abnormal new vessels develop at the rotator interval and axillary recess — the areas that hurt most at night and at end range of motion. Frozen shoulder often improves on its own over one to three years, but that is a long time to live with severe pain. Embolization aims to shorten the painful phase so physical therapy can restore motion.

The same approach is used for rotator cuff tendinopathy and shoulder impingement that has not responded to therapy or injections^[1,9,10].

Typical symptoms

Deep shoulder pain, worse at night
Loss of motion — reaching overhead or behind the back
Pain that persists despite therapy or steroid injection

Illustration of an inflamed shoulder capsule with abnormal new vessels at the rotator interval and axillary recess in frozen shoulder — Illustration for patient education.

What the studies show

A 2026 systematic review and meta-analysis (12 studies, 329 shoulders) found large gains in external rotation and shoulder function scores at 3–6 months, with 100% technical success and no severe adverse events^[5].
In the largest single series (118 patients), average pain fell from 7.8 to 2.2 out of 10 at six months, forward flexion improved from about 90° to 143°, and 89.8% reported improvement at one year^[6].
A 2026 comparative study found embolization and arthroscopic capsular release produced similar results at six months^[7].

Elbow

Tennis Elbow & Golfer's Elbow

Access: Wrist (radial artery) Evidence: Prospective + retrospective series

Lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer's elbow) are overuse injuries of the tendon attachments at the elbow. When pain persists for months, ultrasound and MRI often show abnormal new vessels in the degenerated tendon. Embolization of these small vessels is an option for patients who have not improved with bracing, therapy, or injections and who want to avoid surgery.

Typical symptoms

Pain on the outer (tennis) or inner (golfer's) elbow
Pain gripping, lifting, or shaking hands
Symptoms lasting more than 3 months

Illustration of lateral epicondylitis (tennis elbow) showing abnormal new vessels at the common extensor tendon origin — Illustration for patient education.

What the studies show

In a pilot study with two-year follow-up (24 patients), arm-function disability scores (QuickDASH) improved from 50.8 to 2.7, and MRI findings improved^[11].
For golfer's elbow, a single-center cohort reported clinical success in 85.7% of patients^[12].
In a series of shoulder and elbow tendinopathy, 73% of patients achieved clinical success^[9].

Hand

Thumb-Base & Finger Arthritis

Access: Groin (femoral artery) Evidence: Prospective + retrospective series

Arthritis at the base of the thumb (trapeziometacarpal or CMC joint) and in the finger joints can make pinching, opening jars, and typing painful. Inflamed joint lining in these small joints develops the same abnormal vessels seen in larger joints. For patients who are not ready for surgery, embolization can reduce pain while preserving the joint.

Typical symptoms

Aching at the base of the thumb
Painful, swollen finger joints
Weak pinch or grip

What the studies show

In a prospective study of thumb-base arthritis (31 patients), pain fell from 7.2 to 2.5 out of 10 at two years, and 77% reported improvement at two years^[13].
In 92 patients with finger-joint arthritis, pain fell from 7.8 to 4.0 at 12 months, with 77% meeting the clinical-success threshold^[14].
A 2026 prospective U.S. series of thumb-base arthritis reported at least 50% pain improvement at six months in 79% of patients^[15].

Hip

Hip Arthritis & Lateral Hip Pain (GTPS)

Access: Groin, wrist, or foot Evidence: Prospective + retrospective series

Hip osteoarthritis and greater trochanteric pain syndrome (GTPS) — pain over the outside of the hip from gluteal tendinopathy and bursitis — are both driven in part by inflamed, hypervascular tissue. Embolization targets branches of the circumflex femoral arteries that supply these tissues. It is best suited to patients with mild-to-moderate arthritis, patients who are not surgical candidates, and patients who want to delay hip replacement. Depending on anatomy, Dr. Fischman approaches the hip from the groin, the wrist, or the foot.

Typical symptoms

Groin or outer-hip pain with walking
Pain lying on the affected side
Not ready for, or not a candidate for, hip replacement

What the studies show

In the prospective HipE study (49 patients with hip arthritis or GTPS), pain fell from 7.8 to 4.0 out of 10 at 12 months, and 73% achieved clinical success; results were similar for arthritis and GTPS^[16].
In a 41-patient series treated with temporary embolics, median pain fell from 7 to 4 at 12 months, and only two patients (4.9%) went on to hip replacement during follow-up^[17].
For GTPS specifically, a registry with midterm follow-up reported pain scores of 0–3 out of 10 in 21 of 37 treated hips^[18].

Foot

Plantar Fasciitis (Heel Pain)

Access: Groin (femoral artery) Evidence: Prospective + retrospective series

Chronic plantar fasciitis causes sharp heel pain, classically with the first steps in the morning. Most cases resolve with stretching, orthotics, and time, but a subset persists for many months. In chronic cases, abnormal vessels develop at the fascia's attachment to the heel bone. Embolization of the small calcaneal branches offers a non-surgical option when conservative care — including shock-wave therapy or injections — has failed.

Typical symptoms

Heel pain with the first steps in the morning
Pain after standing or walking
Symptoms lasting more than 3–6 months

Illustration of chronic plantar fasciitis showing abnormal new vessels at the plantar fascia origin on the heel — Illustration for patient education.

What the studies show

In 66 patients followed for up to four years, foot-function scores (AOFAS) improved from 65.8 to 92.8 at one year, and improvement was maintained through long-term follow-up^[19].
In a prospective study (32 patients), pain fell from 7.3 to 1.3 out of 10 at six months^[21].
A 2026 series reported clinical success in 72.7% of patients at six months, sustained at 12 months^[20].

Ankle

Achilles Tendinopathy

Access: Groin (femoral artery) Evidence: Multicenter + prospective series

Chronic Achilles tendinopathy — pain and thickening of the Achilles tendon, either in the midportion or at its insertion on the heel — is common in active adults. Abnormal vessels growing into the degenerated tendon are a hallmark of the chronic phase. Embolization targets those vessels while preserving the tendon's normal blood supply.

Typical symptoms

Pain and stiffness at the back of the heel
Pain with running, stairs, or first steps
A thickened, tender tendon

What the studies show

In a multicenter study of 82 patients, pain fell from 6.7 to 1.5 out of 10 at two years, tendon-function scores (VISA-A) rose from 48.4 to 82.2, and 81.7% achieved clinical success at one year. No tendon ruptures occurred^[22].
A prospective series (18 patients, 20 limbs) reported 94.4% clinical success^[23].

Musculoskeletal Embolization
in New York City

Treating the Blood Supply Behind Chronic Pain

Where It Hurts — and
Where the Catheter Goes In