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Subacromial corticosteroid injection for poststroke shoulder pain: an exploratory prospective case series
1Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, MetroHealth Rehabilitation Institute of Ohio, Cleveland, OH 44109, USA. jchae@metrohealth.org
Archives of Physical Medicine and Rehabilitation
|March 4, 2009
Summary
Subacromial corticosteroid injections effectively reduce poststroke shoulder pain in patients with specific shoulder conditions. However, the pain relief gradually diminishes over time, necessitating further research.
Area of Science:
- Neurology
- Orthopedics
- Pain Management
Background:
- Poststroke shoulder pain is a common and debilitating complication.
- Conditions like supraspinatus impingement, tendonitis, and bursitis contribute to this pain.
Purpose of the Study:
- To evaluate the efficacy of subacromial corticosteroid injections for managing shoulder pain in stroke survivors.
- To assess the impact on pain severity and interference with daily activities.
Main Methods:
- An exploratory, prospective case series involving 10 stroke survivors with hemiparetic shoulder pain.
- Subacromial corticosteroid injections were administered to participants with diagnosed impingement, tendonitis, or bursitis.
- Pain was assessed using the Brief Pain Inventory (BPI) at baseline and various intervals up to 12 weeks post-injection.
Main Results:
- A significant reduction in worst shoulder pain (BPI 12) was observed over time (P<.001).
- The greatest pain relief occurred by week 2, with a subsequent gradual decrease in effectiveness.
- Significant improvements were noted in pain interference with general activity, sleep, and enjoyment of life (BPI 23 domains).
Conclusions:
- Subacromial corticosteroid injections offer significant short-term pain relief for poststroke shoulder pain associated with specific rotator cuff pathologies.
- The therapeutic benefits are not sustained long-term, indicating a need for ongoing management strategies.
- Further controlled trials are required to establish a definitive cause-and-effect relationship and explore long-term outcomes.
