Post Stroke Hemiplegic Shoulder Pain causes- an observational study

Yesh Veer Singh; Anil Gupta; Santhosh Kumar Mathangi; Prabir Mandal

Volume : IX, Issue : VIII, August - 2020

Post Stroke Hemiplegic Shoulder Pain causes- an observational study

Yesh Veer Singh, Anil Gupta, Santhosh Kumar Mathangi, Prabir Mandal

Abstract :

Introduction: Hemiparetic Post Stroke Shoulder Pain (HPSSP) is common complication after Stroke. Common factors contributing to HPSSP include subluxation, spasticity of muscles with imbalance of the gleno-humeral joint, contracture of periarticular soft tissues, rotator cuff tendinitis, complex regional pain syndrome (CRPS). Other significant causes are adhesive capsulitis, subacromial bursitis, achial plexus traction neuropathy, heterotopic ossification, thalamic syndrome (also known as central post stroke pain syndrome) and soft tissue injury or trauma. Objectives: To study the common causes of post stroke shoulder pain to develop better understanding. Materials & Methods: 107 subjects of hemiparetic Stroke patients of both sexes from urban & rural population with complain of shoulder pain who were attending Physical Medicine & Rehabilitation department were selected as per inclusion and exclusion criteria. Assessed patients in detail and analyzed subsequently. Results: Most common cause for Hemiplegic Shoulder Pain Syndrome identified in our study are Subluxation of glenohumeral joint 39%, Adhesive Capsulitis 31%, Rotator Cuff Tendinitis17% and CRPS 4% as per decreasing order of frequency. A few cases of Bicipital Tendinitis, Post stroke central pain and supraspinatus bursitis also landed up with shoulder pain in our study group. Conclusions: Subluxation of the shoulder joint is the major etiology of shoulder pain followed by adhesive capsulitis, rotator cuff tendinitis, CRPS, bicipital tendinitis. In general, left shoulder joint involvements are much more common than the right shoulder joint involvement. In our study right shoulder joint is mostly affected in case of rotator cuff tendinitis.