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Post stroke shoulder pain: more common than previously realized.

G E Gamble1, E Barberan, D Bowsher

  • 1Department of Geriatrics, Clinical Sciences Building, Hope Hospital, Eccles New Road, Salford M8 6HD, UK. egamble@fsl.ho.man.ac.uk

European Journal of Pain (London, England)
|September 14, 2000
PubMed
Summary

Post-stroke shoulder pain is more common than previously thought, affecting 25% of patients within two weeks. Early detection through thorough neurological exams can identify at-risk individuals for better rehabilitation outcomes.

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Area of Science:

  • Neurology
  • Rheumatology
  • Rehabilitation Medicine

Background:

  • Stroke is a leading cause of disability, often necessitating extensive rehabilitation.
  • Shoulder pain is a frequent complication that can significantly impede recovery and prolong rehabilitation.
  • The actual prevalence and contributing factors of post-stroke shoulder pain remain incompletely understood.

Purpose of the Study:

  • To prospectively evaluate the incidence of shoulder pain in acute stroke patients.
  • To identify clinical factors associated with the development of post-stroke shoulder pain.
  • To inform early detection and risk stratification strategies for post-stroke shoulder pain.

Main Methods:

  • A prospective study involving 123 consecutive acute stroke patients over 6 months.

Related Experiment Videos

  • Assessment at 14 days post-stroke included interviews, rheumatological and neurological examinations, and validated scales (Barthel Index, HAD score, pain scores).
  • Predetermined criteria were used to diagnose shoulder pain, and statistical analysis explored associations with clinical findings.

    • Main Results:

    • Twenty-five percent of patients developed shoulder pain within two weeks of stroke onset.
    • Significant associations were found between shoulder pain and ipsilateral sensory impairment (p < 0.005), abnormal rheumatological examination (p < 0.001), and depression scores (p < 0.005).
    • Upper limb sensory impairment and abnormal shoulder joint examination emerged as key indicators.

    Conclusions:

    • Post-stroke shoulder pain is a common and significant issue, occurring more frequently than previously recognized.
    • Identifying patients at risk requires thorough neurological examination to detect sensory deficits, alongside shoulder joint assessment.
    • Implementing structured proformas for neurological assessment may improve the early identification of patients susceptible to shoulder pain, optimizing rehabilitation pathways.