Shoulder pain in hemiplegia—a literature review

Abstract

Shoulder pain in patients with hemiplegia is a common phenomenon which may impede the process of rehabilitation. Reports of its incidence and prevalence vary widely, possibly due to selective sampling and to a lack of a clear definition of shoulder pain. Many authors acknowledge that its real causes have not yet been clearly identified. A variety of possible causes have been suggested in the literature, often based on clinical observations, rationale and/or correlational studies, but few objective studies have been found to document its aetiology, quantity, characteristics and localisation. Shoulder pain in hemiplegia is thought by some to be entirely preventable by paying attention to the biomechanical aspects of the hemiplegic shoulder. Numerous treatment approaches to shoulder pain have been reported, but they are rarely accompanied by any scientific evidence of their effectiveness. Clear objective information, collected with a sound methodology is needed about all aspects concerned.