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Underlying Pathology and Associated Factors of Hemiplegic Shoulder Pain

Kalichman, Leonid, PT, PhD; Ratmansky, Motti, MD

American Journal of Physical Medicine & Rehabilitation: September 2011 - Volume 90 - Issue 9 - p 768-780
doi: 10.1097/PHM.0b013e318214e976
Literature Review: Hemiplegia

The prevalence of hemiplegic shoulder pain is approximately 22%-23% in the general population of stroke survivors and approximately 54%-55% among stroke patients in rehabilitation settings. Hemiplegic shoulder pain causes a reduced quality-of-life, poor functional recovery, depression, disturbed sleep, and prolonged hospitalization. Herein, we attempted to understand, based on a literature review and experts' opinion, the pathologic processes underlying hemiplegic shoulder pain and the major associated factors contributing to its development. The systematization of underlying pathologies was proposed, which might eventually enable a more constructive clinical approach in evaluating and treating patients with hemiplegic shoulder pain.

From the Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva (LK); and Pain Rehabilitation Unit, Loewenstein Rehabilitation Hospital, Raanana, Israel; affiliated with Tel Aviv University, Tel Aviv, Israel (MR).

All correspondence and requests for reprints should be addressed to: Dr. Leonid Kalichman, PT, PhD, Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, Beer Sheva 84105, Israel.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2011 Lippincott Williams & Wilkins, Inc.