Prevalence of shoulder pain after stroke and some associated factors

Background and Shoulder pain is a common complication of stroke that can cause some rehabilitation limitations to achieve functional goals. The information about its prevalence and associated factors is limited. This study was conducted to detect more details about its associated factors. This study was done on 191 stroke patients at physical medicine and rehabilitation ward of Shiraz-Medical School from 1380 to 1383. Every patient was followed for one year. A questionnaire was prepared containing information about shoulder pain compliant, thorough history and physical examination previous history of open heart surgery, scoliosis, limited neck range of motion, type of stroke (based on MRI and brain CT), osteoporesis (based on bone mineral density and X ray) and shoulder adductor muscles and biceps spasticity (based on ashworth scale). In the following visits in every 2 months until one year, the questionnaire was filled again and if present, shoulder pain was recorded. Most patients developed shoulder pain between 2 and 6 months after stroke. Forthy-nine patients (32.2%) developed shoulder pain, 39(79.6%) of whom had spastic tone and 8 (16.3%) had flaccid tone. In both groups, with shoulder pain and without shoulder pain, respectively 6.7% and 1.9% had a history of open heart surgery, 6.1% and 1% had scoliosis, 67.3% and 35.1% had Intracranial hemorrhage, 73.5% and 23.3% had limited neck range of motion, 24.5% and 35% had osteopenia. Spasticity was significantly more common in the shoulder pain group (a<0.001), which can be due to capsulitis, soft tissue inflammation (especially ligament and rotator cuff muscle) and anteroinferior subluxation of the shoulderThere was a significant statistical correlation between Intracranial hemorrhage reduced neck range of motion, and hemiplegic shoulder pain. It seems that, treatment and rehabilitation of spasticity and underlying cervical area problems are helpful in preventing hemiplegic shoulder pain.