For patients
Joint or tendon pain
Joint pain due to osteoarthritis (OA) is a leading cause of disability among older adults. IRs can help treat knee osteoarthritis, tennis elbow and frozen shoulder.
Pain Management
Embolization
Ablation
Overview
Minimally invasive pain management
Joint pain due to osteoarthritis (OA) is a leading cause of disability among older adults. Long thought to be a result of “wear and tear” due to repetitive motion, there is a growing body of evidence that, as the cartilage breaks down, it releases enzymes that can cause inflammation and pain, as well as abnormal blood vessels and nerve fibers development, resulting in pain and limiting function.
When medical management, such as over-the-counter pain medications, and alternatives like heat, massage, acupuncture and physical therapy, don’t work, an interventional radiologists can provide minimally invasive treatments using imaging guidance to target the blood vessels and nerve fibers causing the pain.
What kinds of joint and tendon pain can IRs treat?
IRs can help treat the following conditions:
Knee osteoarthritis, which is caused by the breakdown of cartilage in the knee over time, causing the bones in the knee to rub together. You are at risk of OA in your knees if you are overweight, or engage repetitive activities, such as sports.
Tennis elbow, which is caused by overuse and repetitive stress to the tendons and muscles around the elbow. It typically affects people who play sports with repetitive swinging motions, such as tennis or golf, but it can also affect job performance of carpenters, cooks, assembly-line workers and others. While pain is a hallmark symptom, chronic tennis elbow can cause loss of grip and arm strength, limited use of the arm, and burning sensations on the outer portion of the arm.
Frozen shoulder, also called adhesive capsulitis, is stiffness and pain in the shoulder joint that results in a loss of range of motion that worsens over time.
IR treatments
How do IRs treat joint and tendon pain?
Until recently, arthritis pain was regarded as a “wear-and-tear” disease, but as the cartilage breaks down it releases enzymes that can cause inflammation and pain, and limit functioning.
Interventional radiologists can use a technique called embolization to cut down the abnormal blood flow to reduce inflammation. Embolization is when an interventional radiologist uses image guidance to insert a needle into the blood vessels to release medical materials or devices to temporarily or permanently stop blood flow. There are different types of embolization for the treatment of joint or tendon pain.
Interventional radiologists can also target the nerves causing pain using techniques such as ablation, which destroys damaged nerves allowing them to regrow healthy.
Such treatments can be applied to the following conditions:
Knee pain
- Geniculate artery embolization (GAE) is a minimally invasive, image-guided treatment that blocks key arteries in the knee to reduce inflammation and pain. Studies show GAE can achieve significant pain reduction and improvements in range of motion, avoiding more invasive measures, such as total knee replacement, and relief can last for up to 2 years.
- Geniculate nerve radiofrequency ablation (GNRA) is performed by an interventional radiologist using image guidance to place probe needles next to the nerves of the knee that can send pain signals to the brain. The probes generate radio waves, creating a ball of heat to dull or destroy the pain nerve endings. These nerves do not control muscles or affect balance, making the procedure safe. In clinical studies, the treatment has been shown to last for approximately 6 months to up to 2 years.
Tennis elbow
Transcatheter arterial embolization (TAE) is an image-guided, non-surgical treatment that decreases abnormal blood flow to the injured area to reduce inflammation and pain. The treatment can be completed in approximately 1 hour and requires only a tiny needle hole to access the radial artery in the wrist under local anesthesia. A catheter is moved through the wrist to the elbow where the inflamed blood vessels are embolized, preventing excessive blood flow to the affected part of the elbow.
Frozen shoulder
Arterial embolization of the shoulder (AES), is performed by an interventional radiologist who inserts a catheter through a pinhole-sized incision in patients’ wrists that was used to feed microsphere particles into as many as six arteries in the shoulder to reduce inflammation. The treatment is conducted on an outpatient basis and takes approximately one hour.
Follow up and recovery
What is the treatment’s recovery like?
These procedures are performed on an outpatient basis, meaning patients can go home the same day following a period of observation. Due to the minimally invasive nature of the treatments performed by an interventional radiologist, the recovery time often ranges from just a few minutes to a few days, depending on the procedure.
After the treatment, your interventional radiologist may prescribe a short course of pain medication, physical therapy or other treatments. During a period of regular follow-up appointments, which may include follow-up imaging tests, your interventional radiologist will monitor your progress after the therapy.
Last review
Last reviewed by D. Thor Johnson, MD, and George Zlotchenko, MD. November 2024