Shoulder Pain

Shoulder Pain

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What causes shoulder pain after a stroke?.
Shoulder pain after a stroke can have many different causes. It is extremely important to know the cause of the shoulder pain. Pain can come from damage or injury to the shoulder joint. Pain can also occur when damage has occured to the “pain centers” in the brain and from “non-use” of the arm effect by the stroke. Here is a list of the most common causes and management of shoulder pain following stroke.
Shoulder Subluxation

Pain can occur if the weak shoulder becomes subluxed (partially dislocated) after a stroke. When the shoulder is weak, it becomes extremely unstable. In some cases, the weight of the arm can cause the arm to separate from the the shoulder socket. In most cases, this type of injury is preventable by protecting the shoulder joint and educating care takers on how to assist a patient without pulling on the effected arm.

Adhesive Capsulitis or “Frozen Shoulder”

Another complication that can occur in the shoulder after a stroke is adhesive capsulitis. If the arm stays in one position, sometimes the structures around the joint with “freeze up”. This is where the term frozen shoulder comes from. The capsule around the shoulder joint shortens and will not allow the shoulder to move. If this occurs, the patient usually experiences the most pain with shoulder movement.

Central Neuropathic Pain

A stroke can sometimes effect the areas of the brain that interpret pain. When this happens, the brain may perceive certain sensations as painful.

Complex Regional Pain Syndrome

Complex regional pain syndrome is a condition that occurs when nerves can become hypersensitive due to “non-use” of the arm. This condition aligns with the old saying “if you don’t use it, you lose it”. This can sometimes happen if the patient experiences pain in the arm early on in the recovery. This sends a message to the brain that “movement causes pain”. Once the brain and the patient associate movement with pain, they may go to great lengths prevent the arm from being moved. In sever cases, they may even stop allowing any kind of touch on the arm. If this continues, the arm will become intolerant to any kind of touch or movement.

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