Comments on Acupuncture in Post-Stroke Shoulder Pain Syndrome with Multiple Sclerosis: A Case Study

AbstractPain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, and headache. The pathophysiologies of these PSP subtypes are not yet clearly understood, and PSP is refractory to conventional treatment in many patients. However, recent studies have proposed potential pathophysiologies of PSP subtypes, which may help prioritize therapies that target specific mechanisms.

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Clinical overlap of functional neurologic symptom disorder and complex regional pain syndrome in pediatrics: A case report

Journal of Pediatric Rehabilitation Medicine ◽

10.3233/prm-200700 ◽

2021 ◽

pp. 1-8

Author(s):

Heidi Kempert

Keyword(s):

Complex Regional Pain Syndrome ◽

Pain Syndrome ◽

Gait Pattern ◽

Rehabilitation Program ◽

Neurologic Symptom ◽

Physical Mobility ◽

Unsteady Gait ◽

Full Day

This case study documents a 13-year-old female who presented to our intensive inpatient chronic pain rehabilitation program with complex regional pain syndrome (CRPS) of her left leg, which was significantly interfering with her normal daily functioning. She participated in a full day of traditional interdisciplinary therapies, including physical and occupational therapy for 3 hours daily. As assistive equipment was altered or weaned her physical mobility, balance, and tremors worsened and/or increased. As she began advancing her legs more independently (versus requiring physical assist), she demonstrated more variable functional strength and stability, inconsistent balance reactions, and a more unsteady gait pattern. The team was treating her according to her incoming CRPS diagnosis; however, as treatment progressed, her physical and psychological presentation seemed more aligned with diagnostic criteria of functional neurologic symptom disorder (FND). Staff then treated according to the FND diagnosis resulting in successful long-term outcomes. The clinical impact from this case study includes highlighting the commonalities between CPRS and FND clinically, discussing differentiating treatment suggestions depending on the diagnosis, and emphasizing key components of family/patient education.

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Results availability for analgesic device, complex regional pain syndrome, and post-stroke pain trials

Pain ◽

10.1016/j.pain.0000000000000009 ◽

2015 ◽

Vol 156 (1) ◽

pp. 72-80 ◽

Cited By ~ 3

Author(s):

Faustine L. Dufka ◽

Troels Munch ◽

Robert H. Dworkin ◽

Michael C. Rowbotham

Keyword(s):

Complex Regional Pain Syndrome ◽

Pain Syndrome ◽

Post Stroke

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A randomized controlled trial of strapping to prevent post-stroke shoulder pain

Clinical Rehabilitation ◽

10.1191/0269215500cr339oa ◽

2000 ◽

Vol 14 (4) ◽

pp. 370-380 ◽

Cited By ~ 63

Author(s):

H C Hanger ◽

P Whitewood ◽

G Brown ◽

M C Ball ◽

J Harper ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Shoulder Pain ◽

Controlled Trial ◽

Post Stroke ◽

Randomized Controlled

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Abstract WP314: Frequency and Characteristics of Hemiplegic Shoulder Pain - A Population-Based Assessment

Stroke ◽

10.1161/str.44.suppl_1.awp314 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Zoe A Allen ◽

Keyword(s):

Visual Analogue Scale ◽

Shoulder Pain ◽

Analogue Scale ◽

External Rotation ◽

South Australia ◽

Population Based ◽

Active Movement ◽

Range Of Movement ◽

Stroke Incidence ◽

Post Stroke

Background: Shoulder pain is common complication of stroke with multiple aetiological mechanisms but there are few population-based studies of the clinical profile, frequency and impact of the disorder. Objectives: To determine the frequency and characteristics of hemiplegic shoulder pain in the first year after stroke. Methods: Data on any shoulder pain were obtained in patients registered in a population-based stroke incidence study undertaken in a defined area of the western suburbs of Adelaide, South Australia, over a 12-month period to July 2010. Subjective (any, onset, severity [visual analogue scale] and aggravating factors) and three objective (modified Neer test, passive hand-behind-neck, and passive external rotation) measures of pain were undertaken at baseline, and 4 and 12 months post-stroke. Results: Among 301 stroke patients, shoulder pain data were available for 198 (66%), as 62 had died prior to the 4 month assessment and 41 either refused or were unavailable for assessment. Information on shoulder pain was available from 198 stroke survivors at baseline, 156 at 4 months and 148 at 12 months. Overall, 10% reported shoulder pain at baseline, whilst 21% reported pain at both follow-up assessments, so that overall approximately one third (27%) of patients reported some shoulder pain during 12 months post-stroke. The median pain score (visual analogue scale = 40) was highest at 4 months, and the characteristics varied from mild and prominent at rest (including night) in the early weeks, to being more associated with limited range of movement and aggravated by active movement towards 12 months, suggesting increasing musculoskeletal contributions to pain over time. Objective passive range of motion tests were associated with higher frequencies of pain than were elicited by self-reports. Conclusions: The frequency of post-stroke shoulder pain was similar to other population-based studies, suggesting limited progress in prevention and management of this complication. As the disorder is most common and severe after hospital-discharge, targeted protocols may facilitate identification and management.

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CASE STUDY: MANAGEMENT OF PATIENT WITH SHOULDER PAIN BY GENERAL PRACTITIONER

Odes’kij medičnij žurnal (The Odessa Medical Journal) ◽

10.54229/2226-2008-2021-5-13 ◽

2021 ◽

Author(s):

V. M. Nazarian ◽

V. I. Velichko ◽

V. I. Synenko ◽

S. F. Kovalenko

Keyword(s):

General Practitioner ◽

Rotator Cuff ◽

Shoulder Pain ◽

Pathological Process ◽

Autologous Plasma ◽

Appropriate Treatment ◽

Inflammatory Drugs ◽

Pharmacological Method ◽

Reduced Mobility

Shoulder pain is one of the most common presentations of musculoskeletal pain with population prevalence of between 7 and 26 %. The most common pathology that affects the shoulder joint is rotator cuff syndrome. The most important aspects in the management of patient with shoulder pain by general practitioner are to ensure an accurate diagnosis and to start the appropriate treatment on time. The main direction of rotator cuff syndrome treatment includes a period of rest from the exacerbating activity and taking nonsteroidal anti-inflammatory drugs. In some cases the use of the NSAIDs is not possible, so we decided to suggest an alternative non-pharmacological method of treatment. We treated a patient with rotator cuff syndrome by injections of autologous plasma into the affected muscles and projections of entheses that were involved in the pathological process. We obtained positive results. The shoulder pain had been reduced, mobility and movement had been improved after a course of autologous plasma injections. In our opinion, it is expedient to consider such treatment of the rotator cuff syndrome both as an additional method and separately in case of impossibility of prescribing the main therapy.

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