What is the difference between TAME microvascular embolization and long-term steroid pain relief? Action mechanisms, applicable situations, and evaluation methods

For those who have been suffering from intractable pain for a long time and have tried all kinds of conservative treatments, "coexisting peacefully with pain" is not necessarily the only answer.
TAME (Transcatheter Arterial Micro-Embolization) is one of the interventional treatment options for this type of pain. The goal is to reduce abnormally proliferating microvessels around the joints, thereby decreasing ongoing inflammation and pain signals. Whether it is suitable for you requires evaluation by a physician; this article explains its differences from long-term steroid pain relief, which conditions are suitable for evaluation, and how the treatment is carried out.

What is intractable pain? Which groups are suitable for TAME evaluation?

Intractable pain refers to pain that has persisted for a long time, responds poorly to conventional treatments, and significantly affects daily life. The causes may include chronic inflammation, nerve hypersensitivity, or local tissue structural abnormalities. Clinical evaluation criteria include: pain persisting for more than three months, a severity of 5 or higher on the VAS pain scale, and pain that has already affected sleep, work, or exercise.

There are three common groups for evaluation: First, those with long-term chronic pain in areas such as osteoarthritis, frozen shoulder, tennis elbow, trigger finger, and plantar fasciitis; second, those who have tried medication, rehabilitation, hyaluronic acid, or PRP injections, but still get limited results; third, those who do not want direct surgery, or who continue to experience pain after joint replacement or arthroscopic surgery. It must be clarified that TAME has specific indications and is not suitable for all chronic pain; it still must be determined by a physician based on medical history, physical examination, and imaging.

Why do the effects of long-term steroid injections for pain relief become increasingly limited?

Because steroids suppress the inflammatory response, not all sources of pain.
After joints or tendons suffer from long-term wear and tear or degeneration, in addition to local inflammation, abnormally proliferating microvessels may also appear, accompanied by newly formed nerve endings that continuously send out pain signals. Steroid injections can temporarily suppress inflammation, but they have no effect on these abnormal blood vessels and nerve structures. Therefore, some people experience a cycle of "injection works, pain returns after a while, and the effective duration becomes shorter and shorter."

In addition, repeated steroid injections in the same area have cumulative considerations, such as the impact on tendons and surrounding tissues, which is why clinical practice usually controls the frequency and total number of injections. Whether to continue injections and at what intervals should be discussed with your physician; patients should not and must not decide to stop the medication on their own.

What is the difference in mechanism between TAME and steroids?

In one sentence: Steroids manage inflammation, while TAME manages abnormal blood vessels. TAME works by delivering embolization drugs to abnormally proliferating microvessels under imaging guidance, causing these vessels to shrink, with the goal of reducing the source of pain signals and alleviating the local ongoing inflammatory state.

Therefore, the relationship between the two is not about "which is stronger," but rather that they target different objects. If the primary source of pain is acute inflammation, steroids have their role; if conservative treatments are repeatedly done with continuously limited results, the source of pain may be related to abnormal blood vessel proliferation, at which point TAME enters the evaluation options. Whichever is suitable must be judged by a physician based on medical history, physical examination, and imaging; they are not mutually exclusive alternatives. If pain recurs after treatment, whether to receive TAME again is also evaluated by the physician based on the situation at that time.

Are postoperative pain and chronic pain caused by sports injuries also within the scope of evaluation?

Yes. In addition to chronic pain caused by degeneration and wear and tear, chronic pain caused by the following conditions can also be included in the evaluation:

Postoperative pain: Some patients still experience residual pain after surgery, with limited improvement from pain relievers or rehabilitation. If this type of pain is related to local abnormal microvascular proliferation, TAME is an option that can be discussed with a physician.

Sports injuries: Joint, muscle, or ligament damage caused by long-term high-intensity training or accidents can sometimes turn into chronic pain, which can be evaluated by a physician to see if the source of pain is suitable for TAME treatment.

Occupational wear and tear: Certain occupations place long-term stress on specific areas due to work patterns. For example, musicians who play the saxophone for long periods repeatedly overuse their finger muscles, which can accumulate to form chronic pain. This type of situation can also be included in the evaluation.

How is TAME treatment carried out? Do I need to be hospitalized?

TAME is performed under local anesthesia. In most cases, hospitalization is not required, and patients can return home after a short period of observation. Catheter-based C-TAME is performed under the guidance of angiography equipment with cone-beam CT (3D tomography) function, using microcatheters for selective embolization; the equipment used at See-Medical is the GE OEC 3D mobile C-arm. The simpler s-TAME is performed by injection under ultrasound guidance, without the need to insert a catheter. The physician will explain which method is suitable based on the depth and complexity of the pain site.
In addition, it is important to specify that TAME has specific indications and is not suitable for all chronic pain. It still must be determined by a physician based on medical history, physical examination, and imaging; those who are allergic to contrast agents, have poor kidney function, or are taking anticoagulant medications should actively inform their physician during the evaluation.

It is recommended to avoid heavy lifting and weight-bearing activities within one to two weeks after the procedure. The actual recovery time will vary depending on the site, treatment method, and work pattern, and the physician will explain the expected recovery period before treatment.

If I am still using steroids, can I stop the medication directly?

No, you cannot stop the medication on your own. People who are currently using steroids (oral or injection) or anticoagulants and antiplatelet drugs should fully inform their physician of their medication status when evaluating TAME, and let the physician determine whether and how to adjust it. Stopping medication on your own may bring risks to the control of the original disease, which is more important to avoid than the pain itself.

How do I evaluate if I am suitable?

If your pain has lasted for more than three months, conservative treatment has had limited effects, and you are temporarily not considering surgery, you can first conduct a pre-evaluation through LINE. During your clinic visit, bring your past imaging data (X-ray, MRI, ultrasound) and treatment records. After the physician confirms the source of the pain, you can then discuss whether TAME or other treatment methods are suitable.

What else can be done besides treatment?

TAME addresses the element of abnormal blood vessels; however, long-term pain management usually requires a multi-pronged approach. Physical therapy improves blood circulation and joint mobility through exercise, massage, and hot compresses. Long-term pain can also easily affect mood, and psychological counseling or support groups can assist with stress management if necessary. Lifestyle adjustments such as a balanced diet, regular exercise, and adequate sleep are also part of pain management. It is recommended to discuss a personalized treatment plan with your medical team and view TAME within the context of overall care rather than as a single solution.

Written by: Dr. Ping-Hsing Lu
Professional Review: Dr. Ping-Hsing Lu 2026/07/25

Disclaimer: This article is for health educational purposes and cannot replace medical diagnosis and treatment advice. Whether any treatment is suitable should be determined after evaluation by a physician.

References:

1. Okuno Y, Korchi AM, Shinjo T, Kato S, Kaneko T. Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(7):995–1002. (PubMed: 28365171)