Shoulder pain in hemiplegia.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Orthopedics

Background:

• Shoulder pain is a frequent complication following stroke, significantly hindering functional recovery in hemiplegic patients.
• Numerous potential causes exist, including subluxation, capsulitis, tendinitis, rotator cuff injuries, bursitis, impingement syndrome, spasticity, complex regional pain syndrome, brachial plexus injuries, and proximal mononeuropathies.
• Multiple pathologies may coexist within a single patient, complicating diagnosis and treatment.

Purpose of the Study:

• To review the common causes and management of shoulder pain in poststroke hemiplegia.
• To highlight the importance of prompt diagnosis and appropriate interventions.
• To emphasize the need for further research into the natural history and underlying mechanisms of shoulder pain in this population.

Main Methods:

• Literature review of suggested pathologies causing shoulder pain in hemiplegia.
• Discussion of the controversial relationship between shoulder subluxation and pain.
• Emphasis on the standard of care for upper limb support to manage subluxation.

Main Results:

• Shoulder pain is a prevalent issue in hemiplegia, affecting functional outcomes.
• Various pathologies are implicated, often occurring concurrently.
• Prompt diagnosis and management lead to improvement in many cases.

Conclusions:

• Effective management of shoulder pain in hemiplegia relies on accurate diagnosis and timely intervention.
• While the role of subluxation is debated, upper limb support is a recommended measure.
• Further research is required to understand the natural history and identify physiological factors for improved treatment and prevention strategies.