Shoulder Pain in Stroke Survivors: How to Identify Common Causes and Solutions

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Sep 16, 2020

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Know a stroke survivor with shoulder pain? Its a common complaint, and a major source of anxiety for survivors and caregivers alike. Shoulder pain affects stroke survivors independence and long-term quality of life. Yet, survivors often struggle to have their pain adequately addressed. The following is a discussion of 2 frequent contributors to shoulder pain in stroke survivors, how to recognize them, and potential methods of treatment.
Contributor 1: Physical injury. Physical damage to the shoulder can pre-date stroke, but may also occur due to accidental mishandling/poor positioning of the limb. Stroke survivors commonly experience changes in muscle tone, sensation, or both. Structures that are too loose or tight can easily become torn or injured.
Signs of physical injury: Pain can be pin-pointed. May be triggered with a specific movement, activity, or position. Pain quality may be sharp, sudden, throbbing, or achy.
Contributor 2: Central Pain Syndrome (CPS). CPS is pain resulting from damage to the brain, rather than damage to the shoulder. The stroke survivor perceives pain, but no physical injury is present. This DOES NOT mean that the pain the person feels is not real. CPS is as real as any pain felt following injury to the body.
Signs of CPS: Pain is harder to pin-point. May be constant. May be triggered by gentle touch. Pain quality may be numb, tingly, burning, aching, or sharp.
IMPORTANT: The symptoms for each type of pain are not always straight-forward. Both types of pain CAN exist simultaneously.
So, what can be done?
For pain due to physical injury, the injury must be treated. Depending on available shoulder movement, treatment might include targeted exercise, stretching, manual therapy, task/environmental adaptation, positioning, and modalities.
For pain due to CPS, methods such as mirror therapy, meditation, and sensory re-education might be used. Because pain causes are complex, experienced therapists use a customized combination of methods to achieve the best results.
Whatever underlies pain, its imperative that the survivor be treated with compassion and empathy. Easing painful shoulders after stroke requires a high level of skill. Showing you care is easy, and can also provide welcome relief.
Author, Emilia Bourland, is an occupational therapist and the owner of AIPC Therapy, a mobile therapy practice serving the greater DFW area. You can contact her by calling 469-998-1245 or sending an e-mail to [email protected]

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listed by Encompass include technologies such as LiteGait, Vector, VitalStim Plus, and other rehabilitation systems.Technology does not replace therapyit supports the clinician's treatment plan.Family and Discharge PlanningRehabilitation is ultimately intended to prepare the patient for the next setting.The care team may include: Physicians Nurses Therapists Dietitians Pharmacists Case managers Family members may be included in training when they will be assisting after discharge.FOX RehabilitationPhone: 854-222-4766FOX Rehabilitation is a clinician-operated therapy practice built around its Geriatric House Calls model.The practice provides: Physical therapy Occupational therapy Speech-language pathology primarily to older adults in their homes and senior living communities.A Different Stage of Stroke RecoveryFOX is not an inpatient rehabilitation hospital.Its model can be particularly useful after someone has returned: Home To independent living To assisted living To another senior residence and still needs skilled therapy.FOX describes its services as outpatient therapy delivered through Medicare Part B in the patient's living environment.Physical Therapy at HomeA FOX physical therapist may address: Walking Balance Strength Endurance Fall risk Mobility The advantage of home-based therapy is that the therapist can work with the individual's actual: Stairs Furniture Bathroom Hallways Outdoor walking environment rather than simulating those conditions in a clinic.Occupational Therapy in the HomeOccupational therapy can be especially relevant after stroke because the therapist can observe how the individual actually performs daily activities.Treatment may address: Dressing Bathing Grooming Meal preparation Home management Safety Adaptive equipment FOX's current SBB profile also highlights home-safety assessment and caregiver education as parts of occupational therapy.Speech-Language TherapyFOX speech-language pathologists can address: Speech Language Cognition 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