Shoulder-hand syndrome in a hemiplegic population: a 5-year retrospective study

From 1969 through 1973, 68 (12.5%) of 540 rehabilitation inpatients with hemiplegia were diagnosed as having shoulder-hand syndrome. Care was used to distinguish these patients from those with other shoulder pathologic conditions and pain syndromes. Patients were evaluated with respect to side of hemiplegia, dates of onset of hemiplegia and of pain, age, sex, handedness, sensory losses, associated medical diseases and treatment response. All patients became pain-free within three weeks with a therapeutic regimen of low doses of steroids orally, passive range of motion to pain tolerance, use of a hemiplegia sling and the application of physical modalities for symptomatic relief. Losses of range of motion in the affected extremity responded less well to treatment. No complications or side effects attributable to steroids were observed. The full syndrome recurred in six patients, all of whom responded to a second course of treatment.