Shoulder Anterior Capsular Block and Intraarticular Steroid Injection Versus Intraarticular Steroid Injection for Enhancing Pain Relief in Adhesive Capsulitis

Inclusion Criteria: * Patients acceptance * Age: 41-65 years old * Sex: both sex (males or females). * Physical status: American Society of Anesthesiologist (ASA) І, II. * Patients attend orthopedic or pain clinic with complaint of shoulder pain and stiffness. These patients received conservative management of pain with no relief of symptoms for at least 2 weeks. Exclusion Criteria: * Shoulder pain due to secondary causes, e.g. acute trauma, fractures, bony deformity, glenohumeral joint pathology, acromioclavicular joint pathology and rotator cuff disorder. * Patient with any contraindications of regional blocks (as coagulopathy or local infection at injection site) * Patients with known history of allergy to the study drugs (bupivacaine and methylprednisolone). * Advanced hepatic, renal, cardiovascular, neurologic and respiratory diseases, uncontrolled diabetes mellitus and thyroid. * History of neuropathy in the involved limb or previous revision surgery.