Shoulder Embolization Consultation: What to Bring and Ask

Quick Answer

Bring your shoulder imaging, a list of every treatment you have tried and how it worked, your medical history and medications, and your insurance details. Expect a history, a range-of-motion exam, an imaging review, and an honest discussion of whether embolization or another option fits you.

A consultation is where you find out whether shoulder embolization actually makes sense for your shoulder, and where you get to ask every question on your mind. A little preparation makes the visit far more useful. This guide covers what to bring, what usually happens during the appointment, and the questions that will help you make a confident decision, whether that decision is embolization or something else.

Before your visit: what to gather

Imaging. Bring reports and, if possible, the actual images from any shoulder X-rays, MRI, or ultrasound. Several embolization studies used MRI to look at the capsule and rotator cuff before treatment.
A treatment history. List what you have tried and roughly when: physical therapy (how many weeks), medications, steroid injections (how many and how long each helped), hydrodilatation, or surgery. Published studies generally included only people whose symptoms continued despite these treatments, so this list matters.
Your symptom timeline. When did the pain start? Has it changed? Is night pain the worst part, or is stiffness?
Medical history. Note diabetes, thyroid disease, kidney problems, bleeding disorders, artery problems in the arms, and any past reaction to contrast dye.
Medication list. Include blood thinners, diabetes medicines, and supplements.
Insurance information. Bring your card and any letters you have received from your plan.

A sample one-page summary

A simple one-page summary saves time and makes sure nothing important is missed. It might look like this:

Right shoulder pain since last March, worst at night, cannot sleep on that side
Physical therapy twice a week for 10 weeks, small gains in reach
Two steroid injections, each helped for about 6 weeks
MRI in August: thickened capsule, no rotator cuff tear
Type 2 diabetes, on metformin; no kidney problems; no contrast allergy
Goal: sleep through the night and lift my arm to the top shelf at work

That last line is easy to skip, but it may be the most important one. Clear goals help your doctor judge whether any treatment is likely to deliver what matters to you.

What usually happens at the consultation

Your story. The doctor will ask how the shoulder affects sleep, work, and daily life, and what you hope to get back.
A physical exam. Expect your active and passive range of motion to be measured, along with strength testing and a check of the neck. The doctor may also check the pulse at your wrist, since the wrist artery is commonly used for access.
Imaging review. Your existing images will be reviewed. If something important is missing, such as an MRI to check the rotator cuff, it may be ordered.
A candidacy discussion. The doctor will explain whether you fit the profile studied for embolization, or whether another approach makes more sense. Our guide to who is a candidate outlines the usual criteria.
Next steps. This may include blood tests, insurance verification, or a referral back to physical therapy or an orthopedic colleague.

Questions about whether it is right for you

Based on my exam, is my main problem pain, stiffness, or both?
Have I had enough conservative care, or should I try something else first?
Does anything in my history, such as diabetes or a rotator cuff tear, change the likely result?
What are the alternatives, including doing nothing for now?

Questions about the evidence

A good doctor will welcome these:

What does the research show, and how strong is it? (An honest answer: mostly single-arm studies without a comparison group, with randomized trials now recruiting.)
What results are realistic for someone like me, and over what time frame?
How long have results lasted in studies? (In the longest study, relief held over an average of about 3 years of follow-up.)
What happens if it only partly helps?

For background, read shoulder embolization research and success rates before your visit.

Questions about your treatment options? Dr. Fox can help.

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This article is part of our Embolization Guide.

Questions about the procedure

Will you use the wrist or the groin for access?
What sedation will I receive, and do I need a driver?
Which embolic agent do you use, and why?
How long does the procedure take, and how long will I stay afterward?
Where is the procedure performed?
When can I return to work, drive, and restart physical therapy?

Published studies describe procedures done under local anesthesia, sometimes with light sedation, with a median procedure time of about 33 minutes in one 2024 study. Practices vary, so ask about yours.

Questions about safety

What side effects do your patients most often have?
What are the rare but serious risks, and how do you reduce them?
What symptoms should make me call you, and who answers after hours?

In published studies, side effects have mostly been mild and temporary, such as shoulder ache, skin color changes over the shoulder, and wrist bruising. A 2026 meta-analysis of 329 shoulders reported no severe events, while a rare case of temporary vision loss has been described. See risks and side effects for details.

Questions about cost and coverage

Will your office verify my benefits and request prior authorization?
What will I owe if my plan does not cover it?
Are the consultation, imaging, facility, and follow-up billed separately?

Coverage varies, and insurers that have written policies on joint embolization have mostly classified it as investigational or not medically necessary. Read is shoulder embolization covered by insurance before your visit.

About the physician

At Fox Vein & Vascular in Manhattan, shoulder embolization is performed by David Fox, MD, FACS, RPVI, a board-certified vascular surgeon. Catheter-based work inside arteries is a core part of vascular surgery. Many patients also see an orthopedic surgeon or physical therapist, and coordinating care among them is part of a good plan. Whoever you see, it is reasonable to ask how often they perform shoulder embolization and how they follow their patients afterward. You can read more about the procedure on our shoulder embolization page and how it compares with other joints in the embolization guide.

After the consultation

You do not have to decide on the spot. A few questions can help you sort through what you heard:

Did the doctor explain clearly whether pain or stiffness is my main problem?
Do I understand what the evidence can and cannot tell me?
Do the likely benefits outweigh the risks, cost, and time involved for me right now?
Have I tried the simpler options thoroughly enough?

Again, there is no rush. Take time to review your notes, talk with family, and get a second opinion if you want one. If you notice signs of a more urgent problem in the meantime, such as a hot, swollen shoulder with fever, or shoulder pain with chest pressure or shortness of breath, seek care right away rather than waiting for a scheduled visit.

Frequently Asked Questions

Do I need a referral for a shoulder embolization consultation?

That depends on your insurance plan. Some plans require a referral to see a specialist. Check with your plan or ask the office when you book.

Should I get an MRI before my consultation?

Not necessarily. Bring any imaging you already have. The doctor can decide whether an MRI is needed to check the rotator cuff and capsule.

How long is the consultation?

Allow time for a history, exam, imaging review, and questions. The office can tell you how long to plan for when you schedule.

Can I bring someone with me?

Yes. A family member or friend can help you remember the information and ask questions you might forget.

Keep Reading

Sources

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.

Your Shoulder Embolization Consultation Guide