Adhesive Capsulitis Phase 1 --> Patients in phase 1 will be considered as those in which the predominant clinical picture is pain accompanied by limitation of ROM

Adhesive Capsulitis Phase 2 --> Patients in whom ROM limitation predominates in the face of pain.

First, an SSNB will be performed with 4 ml of 0.25% anesthetic + 0.5 ml of corticosteroid in the suprascapular notch.

After 15 minutes of the SSNB, ultrasound-guided HD will begin. To do this, the patient will be placed in a lateral decubitus position on the unaffected arm. The arm to be treated will be positioned at the patient's side without forcing its extension. The joint cavity will then be approached posteriorly, introducing a spinal needle in the ultrasound plane between the humeral cortex and the labrum. The joint cavity will then be confirmed by introducing physiological saline solution and observing its reflux by pushing the plunger. Subsequently, 5 ml of 0.25% anesthetic + 0.5 ml of corticosteroid will be introduced, and the corresponding volume will be completed with saline solution, this case 20 ml.

The Shoulder Pain Disability Index is a widely used outcome measure in studies that provides information about pain and limitation of shoulder pathologies.

• Pain Scale How severe is the pain? 0 = no pain and 10 = the worst pain imaginable.

  • At its worst?
  • When lying on that side?
  • When reaching for something on a high shelf?
  • When touching the back of your neck?
  • When pushing with the affected arm?

• Disability Scale:

How much difficulty do you have? 0 = no pain and 10 = the worst pain imaginable.

• Washing your hair.
• Washing your back.
• Putting on a T-shirt or sweater.
• Putting on a button-down shirt.
• Putting on your pants.
• Placing an object on a high shelf.
• Lifting a heavy object weighing 4.5 kilograms.
• Taking something from his back pocket.

Then, pain and disability are obtained separately, and a percentage of impairment is combined.

This index has demonstrated "good internal consistency, convergent validity, and reliability" in its Spanish version.

The VAS "is a validated subjective measure for acute and chronic pain." It allows for the measurement of pain intensity with maximum reproducibility.

It consists of a 10-centimeter horizontal line, with the extreme expressions of a symptom at each end. To the left (0) is the absence or lowest intensity, and to the right (10) is the highest intensity. The patient is asked to mark the point on the line that indicates the intensity. The minimally detectable differences for the symptom level to be acceptable are 2 to 3 points.

Range of motion assessment is a basic practice in the study of shoulder pathologies, especially in the case of AC. ROM should be measured, both actively and passively.

The ROMs that will be assessed actively and passively will primarily be flexion, abduction, external rotation (with the arm at 90° of abduction, by asking the patient to show us the palm of their hand), and internal rotation (with the arm at 90° of abduction, by asking the patient to show us the back of their hand). All of these are measured with the PLURIMETER inclinometer.

This will be measured using ultrasound with a longitudinal section of the AR. The patient will be placed supine with the shoulder abducted at 90° and the elbow flexed.

The Lattinen test is a widely used tool for assessing pain, validated in Spain as a tool to measure the degree of pain in patients with chronic pain. This scale consists of five items scored from 0 to 4:

1. Pain intensity.
2. Pain frequency.
3. Analgesic use.
4. Degree of disability.
5. Hours of sleep.

Although this test is widely used in chronic pain conditions, its use in AC is not very common. However, we believe it can provide important data such as analgesic medication intake. This is why we consider its use appropriate.