What are My Treatment Options for Frozen Shoulder?

This article was medically authored by Dr. William Fox and last reviewed for accuracy on 10/16/2026.

If you're struggling with shoulder pain and limits on your range of mobility, you may have been told that manipulation under anesthesia is your next step. But there's another option worth exploring: frozen shoulder embolization, a minimally invasive procedure that targets inflammation without requiring general anesthesia or forceful shoulder manipulation.

Frozen shoulder, medically known as adhesive capsulitis, occurs when the connective tissue surrounding your shoulder joint becomes inflamed, thickened, and tight. The result is persistent pain, stiffness, and difficulty performing everyday activities such as getting dressed, reaching overhead, or even sleeping comfortably.

When physical therapy, medications, and steroid injections fail to provide sufficient relief, patients may consider more advanced treatment options for frozen shoulder. In this post, we compare two of them: Frozen Shoulder Embolization (FSE) and Manipulation Under Anesthesia (MUA). Although both aim to improve your shoulder function, they work in very different ways.

Key Takeaways

• Frozen shoulder is a condition in which inflamed and tightened connective tissue around your shoulder joint causes pain and limits range of motion
• Non-surgical treatment options for frozen shoulder include embolization and manipulation under anesthesia
• MUA may provide immediate improvements in range of motion, but it requires general anesthesia and can result in post-procedural pain
• FSE benefits develop gradually in the weeks following treatment, but it reduces pain and improves mobility while avoiding general anesthesia

What Is Frozen Shoulder Embolization (FSE)?

Frozen Shoulder Embolization is a minimally invasive, image-guided procedure performed by our interventional radiologists at Texas Endovascular.

In some patients with frozen shoulder, small, abnormal blood vessels develop within the inflamed tissues surrounding your joint. These vessels may contribute to ongoing inflammation and pain; FSE aims to block blood flow to the vessels, reducing inflammation and pain and improving your range of motion.

During FSE, we:

1. Make a tiny puncture to access your artery.
2. Use advanced imaging to guide a small catheter toward the blood vessels that supply your inflamed shoulder tissues.
3. Deliver microscopic embolic particles, reducing abnormal blood flow associated with inflammation.
4. Remove the catheter and applies a small bandage.

Benefits of Frozen Shoulder Embolization include:

• No surgical incision in the shoulder
• Avoiding general anesthesia and overnight hospital stays
• No forceful manipulation of the shoulder joint
• Patients resume light activities within a day or two of treatment
• Pain reduces and range of motion improves in the weeks following your procedure

FSE is one of the newer treatment options for frozen shoulder, but early clinical research is encouraging regarding the lasting effects of its benefits.

What Is Manipulation Under Anesthesia (MUA)?

Manipulation under anesthesia is a treatment option that some providers may recommend when frozen shoulder does not respond adequately to conservative interventions.

During this procedure, patients are typically given general anesthesia, so providers can move the shoulder without causing you pain. Once the patient is sedated, an orthopedic specialist moves the affected arm through a series of controlled motions, stretching and disrupting the tight tissues and adhesions that have been restricting shoulder movement.

The goal is to mechanically release the contracted joint capsule and improve range of motion.

Benefits of MUA include:

• The potential for an immediate improvement in shoulder movement
• No surgical incision
• Brief procedure time

However, MUA also has limitations. Because you’re under anesthesia during shoulder manipulation, you run the risk of complications such as fractures, dislocations, rotator cuff injuries, or nerve injuries. Also, there are often higher costs and potential complications directly associated with general anesthesia.

Following the procedure, you may also experience significant discomfort. Plus, to maintain benefits from your procedure, you’ll have to engage in physical therapy and regular stretching.

Comparing Treatment Options for Frozen Shoulder: Embolization vs. Manipulation Under Anesthesia

To help you make the best treatment decision for your needs, here is a breakdown of key differences between FSE vs MUA.

Which Treatment Is Less Invasive?

Both treatments avoid traditional open shoulder surgery, but FSE and MUA involve different types of intervention.

FSE does not require forcefully stretching or disrupting the shoulder capsule. Instead, it uses a small catheter to treat blood vessels associated with inflammation.

MUA does not usually involve an incision, but it requires physically manipulating the shoulder under anesthesia to release contracted tissue.

For patients concerned about general anesthesia or the potential injuries associated with shoulder manipulation, FSE may be an appealing alternative.

How Does Recovery Compare?

FSE is generally performed as an outpatient procedure, allowing patients to return home the same day as treatment. Many patients can resume light activities within one or two days, although individual recovery instructions vary.

Pain relief may develop over several weeks, with improvements in shoulder movement occurring gradually. Physical therapy or home stretching exercises may still be recommended to help restore flexibility.

MUA can produce an immediate increase in passive range of motion following treatment, but patients may experience soreness and inflammation afterward. Physical therapy typically begins promptly after the procedure to help maintain any mobility gained during manipulation.

Recovery varies depending on the severity of the frozen shoulder, your overall health and your response to rehabilitation.

An important distinction: FSE generally aims to reduce inflammation and pain first, while MUA aims to improve movement directly by releasing restricted tissue.

Which Treatment Option for Frozen Shoulder Is More Effective?

Both treatments may improve pain and shoulder mobility, but the evidence supporting them is different.

MUA has been used for decades, although research has not consistently demonstrated that it produces better long-term outcomes than other nonsurgical treatments.

FSE is a newer approach. Early studies suggest that targeting abnormal blood vessels may reduce pain and improve shoulder function in patients who have failed to find relief from conservative treatments.

Your best treatment option will depend on the severity and stage of frozen shoulder, previous treatments, medical history, and whether pain or restricted motion is your most concerning symptom.

Who is a Candidate for Frozen Shoulder Embolization?

You may be a candidate for FSE if:

• You’ve been diagnosed with adhesive capsulitis.
• You have persistent shoulder pain and stiffness.
• Physical therapy, medications, or steroid injections have not provided adequate relief.
• You would prefer to avoid general anesthesia and wish to explore a minimally invasive alternative.

Not every patient with adhesive capsulitis is a candidate for embolization. To learn more about this treatment option for frozen shoulder, we invite you to take our FSE candidacy quiz.