Inclusion criteria:
patients with ages between 18 and 80
active and passive restriction of shoulder range of motion (forward flexion less than 100 degrees, external rotation less than 30 degrees, internal rotation less than L1 vertebra,
Stage 2 or 3 adhesive capsulitis according to the classification of Hannafin and Chiaia
complaint of pain for 1month at least and of ROM restriction for 3 months at least
written consent of participation in study
Exclusion criteria:
shoulder corticosteroids injection in last 6 months
chronic long-term use of oral corticosteroids or in last 2 weeks
history of shoulder surgery, shoulder fracture, shoulder dislocation in last 3 months
shoulder septic or inflammatory arthritis or any evidence in favor of shoulder cellulitis
uncontrolled Diabetes (HbA1C more than 7%, injection day BS more than 300)
cuff full thickness tear or cuff partial thickness tear more than 50% in shoulder MRI
Calcium deposition or Glenohumeral Osteoarthritis in shoulder AP and Axillary Xray
neuromuscular diseases, systemic skeletal diseases, skeletal or soft tissue cancers of shoulder or organs around the shoulder
use of Warfarin, Rivaroxaban, Apixaban, or any evidence in favor of bleeding susceptibility (INR>2, aptt>80 sec, platelet< 50000)