After stroke, shoulder pain is one of the most common complications after stroke. The incidence rate is different from each branch. It is estimated to be between 30% and 85%. It can occur within two weeks at the earliest, and most of it occurs 2-3 months after stroke. Its typical clinical manifestation is hemiplegia side shoulder pain, accompanied by shoulder joint restriction . The pain is more obvious when wearing clothes and shoulder joint lifting. In addition to the shoulder, some patients' pain range can even affect wrists, fingers, etc., causing greater pain, and seriously affecting rehabilitation training and daily life.
There are many reasons for shoulder pain after stroke. Each factor may cause shoulder pain alone, and it can also cause shoulder pain due to multiple factors together.
1. Shoulder joint subluxation
The limpitous period of hemiplegia in cerebral infarction, relaxation of shoulder muscles in the upper limbs can lead to shoulder joint subluxation, forming peripheral nerve compression and soft tissue damage , which can lead to shoulder pain symptoms.
2. Shoulder-hand syndrome
Features are shoulder pain on the affected side and limited exercise (especially severe when passively moving the affected shoulder); hand pain (flexion of the affected side can cause or aggravate the pain), hand swelling, skin temperature rises, and after reducing swelling, the muscles in the hands are atrophy, until contracture deformity.
3. After the upper limb hemiplegia of the patient, muscle tension
After the patient has hemiplegia of the upper limbs, muscle tension may increase, resulting in muscle spasms around the shoulder joint, and the patient's upper limbs are spasmed and bent. Spastic pain may occur when the shoulder joint moves.
4. Shoulder capsule inflammation adhesion
Patients with hemiplegia in stroke are lacking active activity in the muscles around the joint, which causes venous blood and lymph fluid to stagnate, blood circulation is slow, tissue edema occurs, serous fibrous exudates are present, and it is also easy to cause adhesions between joint capsules and muscles.
5. Psychological factors
Research has found that anxiety and depression in patients with chronic pain is common, and this emotion can in turn aggravate the patient's pain feelings and cause a vicious cycle.
Shoulder pain after stroke is one of the most common complications of stroke, and the incidence of shoulder pain can be minimized only by actively preventing it in the early stages of stroke.
