The incidence of hemiplegic shoulder pain (HSP) has been reported as occurring in between 30% -65% of post stroke patients. With around 1/3 of patients developing HSP within 6 months of their stroke. The duration of this pain varies with around 65% of these patients reporting HSP for a number of months. See additional information for references and links to articles (PDF).
All stroke patients should be asked if they are in pain and this should be considered by the MDT to determine the nature and best management of any pain. Where a recommended treatment regime is designed, all staff should be aware of and contribute to this so as to ensure best analgesic control. This will enhance the ability of that patient to take part in physical rehabilitation.
It is important to identify the onset of shoulder pain at the earliest possible moment so that the most appropriate intervention can be initiated. The diagnosis can be made on the subjective report of the patient or, in the case of aphasic individuals, where facial expression or body language indicates pain either at rest or on passive movement. Remember that where joints are misaligned through abnormal tone, passive movements may cause pain due to a failure to give adequate manual support (not because there is damage to the shoulder). Subluxed (partially dislocated) shoulder joints should be handled with extreme caution.
Page last reviewed: 23 Mar 2021
