Recommendation ID
CG162/4
Question
Shoulder pain:- Which people with a weak arm after stroke are at risk of developing shoulder pain? What management strategies are effective in the prevention or management of shoulder pain of different aetiologies?
Any explanatory notes
(if applicable)
Why this is important:- Shoulder pain after stroke is a common problem, with some prevalence estimates as high as 84%. Onset has been reported to occur from 2 weeks to several months after the stroke. Most experts agree that prevention of shoulder pain after stroke is an important goal and should be prioritised as an aim of rehabilitation from the first day after a stroke. However, the means of preventing hemiplegic shoulder pain (HSP) is not universally agreed. This may be due, in part, to the large array of identified causes of HSP. Because of this, there is little agreement on which treatment is best. Treatments include positioning, upper limb support (including slings and orthotics), strapping of the shoulder, range-of-motion exercises, ultrasound, oral non-steroidal anti-inflammatory medications, electrical stimulation for muscle contraction, electrical stimulation for pain relief (TENS), surgery, intraarticular steroid injection, and intramuscular botulinum toxin injections.

Source guidance details

Comes from guidance
Stroke rehabilitation in adults
Number
CG162
Date issued
June 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 15/07/2013