Musculoskeletal (MSK) Embolization for Joint and Tendon Pain in San Francisco

Musculoskeletal (MSK) embolization is a minimally invasive, catheter-based treatment for certain types of chronic joint and tendon pain that have not improved with conservative care. Also called transarterial embolization (TAE) for musculoskeletal pain, the procedure uses imaging to identify small abnormal blood vessels associated with inflammation and pain, then selectively reduces blood flow to those abnormal vessels.

At San Francisco Vein & Vascular Institute, MSK embolization is performed as an outpatient procedure. It may be considered for appropriately selected patients with osteoarthritis, tendinopathy, and other persistent musculoskeletal conditions who have not found adequate relief with treatments such as physical therapy, medication, or injections.

How Does MSK Embolization Work?

Chronic inflammation in some painful joints and tendons is associated with angiogenesis, or the growth of abnormal new blood vessels. These vessels can contribute to an ongoing cycle of inflammation and pain. MSK embolization is designed to interrupt that process by selectively reducing blood flow to these abnormal vessels.

MSK embolization is performed as a minimally invasive outpatient procedure. Using image guidance, a small catheter is guided through an artery to the blood vessels supplying the painful area. Angiography, an X-ray imaging technique that uses contrast dye to show the blood vessels, helps identify the abnormal vessels. Tiny embolic particles are then delivered through the catheter to reduce blood flow to those vessels while preserving normal circulation. The catheter is removed when the procedure is complete, and patients typically return home the same day.

Who is a Candidate for MSK Embolization?

You may be a candidate if you have persistent joint or tendon pain that has not improved with conservative treatment, including:

• Knee: osteoarthritis, sports injuries, tendinopathy Learn more about knee embolization (GAE)

• Shoulder: frozen shoulder (adhesive capsulitis), rotator cuff tendinopathy, chronic pain

• Elbow: Tennis elbow (lateral epicondylitis), golfer's elbow (medial epicondylitis)

• Hip: osteoarthritis, greater trochanteric pain syndrome

• Foot and ankle: chronic tendon or joint pain

• Achilles tendon: Achilles tendinopathy

• Plantar fascia and heel: plantar fasciitis, chronic heel pain

• Wrist, hand, and fingers: arthritis, chronic inflammation

• Other joints and tendons: persistent pain that has not improved with standard treatments

Key Benefits of MSK Embolization

MSK Embolization offers several important advantages for patients living with chronic joint and tendon pain:

Recovery and Results After MSK Embolization

Recovery after MSK embolization is generally quick. Most patients are able to walk and resume routine daily activities soon after treatment, without the prolonged downtime associated with surgery. Some mild soreness or bruising may occur at the catheter insertion site, and patients may be advised to briefly limit strenuous exercise or heavy lifting while that area heals.

Pain relief is typically gradual rather than immediate. As inflammation decreases, patients may begin to notice improvements in pain, mobility, and function over the days and weeks following treatment. The timing and degree of improvement vary depending on the condition being treated and the individual patient.

Research Behind MSK Embolization

Research into musculoskeletal embolization continues to expand, with studies evaluating its use for chronic pain involving the shoulder, elbow, hip, tendons, plantar fascia and other musculoskeletal conditions. While genicular artery embolization for knee osteoarthritis has the largest body of evidence, a growing body of research supports the use of embolization in other areas of the body as well.

Selected research includes:

• Shoulder and Frozen Shoulder: A 2026 systematic review and meta-analysis of 12 studies involving 329 treated shoulders found significant improvements in pain, range of motion, and function, with no severe adverse events reported. View study

• Chronic Tendon Pain: A systematic review and meta-analysis evaluating embolization for rotator cuff, elbow, Achilles, and patellar tendinopathy found significant reductions in pain in patients whose symptoms had not responded to other treatments. View study

• Hip Pain: A 2026 prospective study of patients with hip osteoarthritis or greater trochanteric pain syndrome found significant improvements in pain and function at follow-up, with a 73% clinical success rate reported. View study

• Plantar Fasciitis: A study of 66 patients with persistent plantar fasciitis found significant improvements in pain and function, with benefits maintained during an average follow-up of more than two years. View study

Why Choose SFVVI for MSK Embolization?

At San Francisco Vein & Vascular Institute, we are leaders in minimally invasive treatments for vascular and musculoskeletal conditions. Patients choose us for MSK Embolization because we offer:

• Expertise in MSK Embolization – Our vascular specialists have advanced training and experience treating complex joint and tendon pain.

• Certified Ambulatory Surgery Center – Procedures are performed in a state-of-the-art, accredited outpatient facility focused on safety and comfort.

• Advanced Imaging Technology – We use high-resolution imaging to precisely target abnormal blood vessels and minimize recovery time.

• Personalized Care – Each treatment plan is tailored to your specific condition, goals, and lifestyle.

Frequently Asked Questions

1. How long does relief from MSK Embolization last?
Relief after MSK embolization can be long-lasting. Published studies have reported benefits lasting more than 2 years for some conditions, although results vary by patient and treatment area.

2. What should I expect during and after MSK Embolization?
MSK Embolization is a minimally invasive procedure performed in our certified ambulatory surgery center. It usually takes about an hour, and patients return home the same day. Most experience only mild soreness at the entry site. Recovery is quick, with many resuming normal activities within a few days and noticing gradual pain relief. For detailed recovery tips, visit our Recovery Resources page for the Physical Therapy and Anti-Inflammatory Diet guides.

3. How is MSK Embolization different from surgery?
MSK Embolization does not require large incisions or removal of tissue. It targets inflammation at the source through a tiny catheter, typically allowing for a much quicker recovery and less downtime than surgery.

4. Is MSK Embolization safe?
Yes. MSK Embolization is performed by experienced vascular specialists in a certified ambulatory surgery center. Risks are low, and complications are uncommon.

5. How soon will I feel pain relief after MSK Embolization?
Some patients notice improvement within days. For many, the most significant relief develops gradually over the first few weeks, typically within 2–4 weeks.

6. Does insurance cover MSK Embolization?
Insurance coverage for MSK Embolization varies. Our staff will help you review your insurance benefits and discuss payment options before treatment.

7. Does MSK Embolization help arthritis?
MSK Embolization may provide relief for patients with arthritis by reducing abnormal blood flow and inflammation that contribute to joint pain. For knee arthritis, the procedure is often referred to as Genicular Artery Embolization (GAE). Patients with arthritis in other joints may also benefit, depending on the severity and location of their pain.