Stroke symptoms and arm pain

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Stroke Symptoms: Arm Pain and Shoulder Pain

Arm pain, especially shoulder pain, is a common and significant symptom after a stroke. Many stroke survivors experience pain in the affected arm, which can impact their recovery and daily life Lindgren2007Delpont2018Harrison2015.

Prevalence and Impact of Post-Stroke Shoulder Pain

Shoulder pain develops in about one-third of stroke patients, often within the first few months after the event. Most of these patients report moderate to severe pain, which can restrict daily activities such as dressing and walking Lindgren2007Allison2015. Shoulder pain is not just a marker of stroke severity; it independently predicts poor recovery of arm function and can lead to longer hospital stays Roy1995Allison2015.

Risk Factors for Arm and Shoulder Pain After Stroke

Several factors increase the risk of developing arm or shoulder pain after a stroke:

Poor arm motor function and severe arm paralysis are strong predictors Lindgren2007Hao2021Kim2014.
Shoulder subluxation (misalignment), supraspinatus tendon pathology, and adhesive capsulitis (frozen shoulder) are linked to higher rates of pain Roy1995Kim2014.
Sensory disturbances, such as reduced sensation, and a history of shoulder pain also raise the risk Hao2021Allison2015Kim2014.
Other risk factors include diabetes, limited shoulder joint activity, high muscle tone (spasticity), and hand swelling (oedema) on the affected side Isaksson2013Hao2021.
Patients with hemorrhagic stroke or low general health status are more vulnerable Isaksson2013Hao2021.

Types of Pain Syndromes After Stroke

Stroke can lead to several pain syndromes affecting the arm:

Shoulder pain due to musculoskeletal issues like subluxation or tendon injuries Roy1995Lindgren2007Kim2014.
Complex regional pain syndrome (CRPS), which involves diffuse pain, swelling, and severe functional impairment Topçuoğlu2015Harrison2015.
Central post-stroke pain, spasticity-related pain, and contractures (joint stiffness) are also common Delpont2018Allison2015Harrison2015.

Mechanisms and Symptoms

Chronic post-stroke shoulder pain is often linked to both peripheral injuries (like tendon damage) and changes in the nervous system, such as central sensitization. This can lead to symptoms like allodynia (pain from normally non-painful stimuli) and hyperalgesia (increased sensitivity to pain) . Hand swelling may also occur alongside shoulder pain, indicating more severe injury .

Management and Prevention

Early identification and management of arm and shoulder pain are crucial. Interventions may include:

Physical therapy to maintain joint mobility and prevent contractures Roy1995Allison2015Topçuoğlu2015.
Aerobic exercise and conventional physiotherapy can significantly reduce pain and improve function in conditions like CRPS .
Clinicians should pay special attention to patients with risk factors such as severe arm weakness, sensory loss, or diabetes Hao2021Kim2014Harrison2015.

Conclusion

Arm and shoulder pain are common and serious complications after stroke, affecting recovery and quality of life. Recognizing risk factors and early symptoms allows for timely intervention, which can improve outcomes and help stroke survivors regain function and independence Roy1995Lindgren2007Delpont2018+4 MORE.

Sources and full results

Most relevant research papers on this topic

The effect of shoulder pain on outcome of acute hemiplegia

Shoulder pain is an independent predictor of poor recovery of arm power and function in stroke patients, contributing to longer hospital stays and requiring careful attention.

Highly Cited

1995·

91citations

·C. Roy et al.

Clinical Rehabilitation·

DOI

Shoulder Pain After Stroke: A Prospective Population-Based Study

Almost one third of stroke patients develop shoulder pain within 4 months, with most experiencing moderate-severe pain, and it significantly restricts daily life.

Highly Cited

2007·

331citations

·I. Lindgren et al.

Stroke·

DOI

Shoulder pain and concomitant hand oedema among stroke patients with pronounced arm paresis

One-third of stroke patients with pronounced arm paresis develop shoulder pain, with concomitant hand oedema, and low general status is more vulnerable to developing post-stroke shoulder pain.

2013·

4citations

·M. Isaksson et al.

European Journal of Physiotherapy·

DOI

Pain after stroke: A review.

Pain after stroke is underdiagnosed and undertreated, leading to depression, cognitive troubles, and impairing quality of life.

Highly Cited

2018·

115citations

·B. Delpont et al.

Revue neurologique·

DOI

Risk factors for shoulder pain after stroke: A clinical study

Stroke patients with diabetes, limited shoulder joint activity, Brunnstrom grade I-III, Ashworth 3-4 grade, motor arm score of NIHSS 3-4 points, or sensory disturbance have higher risks for shoulder pain after stroke.

Rigorous Journal

2021·

10citations

·N. Hao et al.

Pakistan Journal of Medical Sciences·

DOI

Incidence, Time Course and Predictors of Impairments Relating to Caring for the Profoundly Affected arm After Stroke: A Systematic Review

Difficulty caring for the arm after stroke is common, with spasticity, pain, and contracture being common impairments, and these impairments develop over time.

Systematic Review

2015·

54citations

·R. Allison et al.

Physiotherapy Research International·

DOI

The effect of upper-extremity aerobic exercise on complex regional pain syndrome type I: a randomized controlled study on subacute stroke

Upper extremity aerobic exercise (UEAE) significantly improves symptoms and signs of complex regional pain syndrome type I in stroke patients, with combined treatment of physiotherapy and aerobic exercises potentially being an excellent synthesis.

RCT

2015·

39citations

·A. Topçuoğlu et al.

Topics in Stroke Rehabilitation·

DOI

Clinical and sonographic risk factors for hemiplegic shoulder pain: A longitudinal observational study.

Patients with severe arm paralysis and supraspinatus tendon pathology are at high risk of hemiplegic shoulder pain in the first 6 months after a stroke.

2014·

49citations

·Y. Kim et al.

Journal of rehabilitation medicine·

DOI

Somatosensory symptoms and signs and conditioned pain modulation in chronic post-stroke shoulder pain.

Chronic post-stroke shoulder pain is associated with central sensitization and possibly disinhibition, highlighting the need for further research on peripheral and central pain mechanisms.

Highly Cited

2011·

83citations

·M. Roosink et al.

The journal of pain : official journal of the American Pain Society·

DOI

Post Stroke Pain: Identification, Assessment, and Therapy

Post-stroke pain is common and underdiagnosed, but effective treatment can improve function and quality of life.

Literature ReviewHighly Cited

2015·

273citations

·Rebecca A Harrison et al.

Cerebrovascular Diseases·

DOI

Try another search

respiratory system diseases

phlegm production in respiratory diseases

prebiotics timing and efficacy

number of adult teeth in humans

anti anxiety medications

modern physicists contributions