Stubborn Shoulder Pain: Image-Guided Options (Including TAME)

What "image-guided, needle-only" means

Image guidance means the doctor uses live imaging - usually ultrasound or X-ray - to see exactly where the needle goes, so the treatment reaches the intended target with precision. "Needle-only" means the procedure is done through a needle rather than an open incision. In practice, this generally allows a same-day procedure and a same-day return home for many people. At YOUNIFY, these are performed by our pain medicine team using internationally accredited techniques and equipment.

These procedures are considered after first-line care, for selected patients whose pain is stubborn - not as a routine starting point.

Common image-guided options for the shoulder

TAME: an emerging option, explained honestly

TAME stands for trans-arterial micro-embolization. To break that down: trans-arterial means the procedure is carried out through the arteries, using a very fine catheter guided by imaging; micro-embolization means gently reducing the flow in tiny, abnormal blood vessels.

Here is the idea behind it. In areas of chronic inflammation - including some cases of frozen shoulder and long-standing tendon pain - the body can grow extra small, abnormal blood vessels, and tiny nerve fibers tend to grow alongside them. These are thought to contribute to persistent pain. TAME aims to relieve pain by targeting those abnormal vessels, calming that process.

It is important to be clear about what TAME is and is not:

• It is an emerging option, used for selected patients with stubborn pain, typically after other measures have not given enough relief.
• It works by relieving pain, not by reversing the underlying condition - it is not a cure.
• Responses vary from person to person, and it is not suitable for everyone.
• Like any procedure, it carries potential risks, which our pain medicine team will discuss with you individually.

TAME should be seen as one more tool that may help certain people be more comfortable and move more easily - a step considered thoughtfully, within a broader plan, rather than a shortcut.

Who might be a candidate?

Image-guided options, including TAME, are generally considered when:

• Pain has persisted despite an adequate trial of physiotherapy and other first-line care.
• A clear diagnosis has been established.
• You would like to explore alternatives before, or instead of, surgery.
• You understand that the goal is meaningful pain relief and better function, with individual results.

Whether any of these is right for you depends on your diagnosis, your health, and your goals. That is decided together with our pain medicine team, and after an appropriate assessment. See how these fit within our full treatment options and our Chronic Pain Care and joint pain services.

What to expect around the procedure

Because these are needle-only and image-guided, they are typically performed with same-day discharge, and many people return to light daily activities soon afterward, following the guidance you are given. Your team will explain preparation, what happens on the day, aftercare, and what recovery may look like for your specific procedure. Being clear about red-flag symptoms beforehand is also wise - our guide to chronic shoulder pain causes and red flags is a useful companion.

If shoulder pain is limiting you, our medical team can assess the cause and options. Contact us on LINE (@younifyclinic) or WhatsApp +66 81 556 9696.

YOUNIFY Clinic - 2nd Floor, Room 214, United Center Building, 323 Silom Road, Silom, Bang Rak, Bangkok 10500 - Open daily 11:00–20:00 - LINE @younifyclinic - WhatsApp +66 81 556 9696. Founded by Dr. Noppachai Siranart (postdoctoral research at Brigham & Women's Hospital / Harvard Medical School, and Mayo Clinic). Physician-led integrative medicine and wellness - Chronic Pain Care.