There are 5 main causes for shoulder pain after stroke.
In this article, you’ll learn how to treat each of these causes and find some relief!
Let’s get started.
Causes for Shoulder Pain After Stroke
Generally speaking, there are 5 main causes for shoulder pain after stroke:
- Shoulder subluxation
- Frozen shoulder
- Central post stroke pain
- Arthritis or inflammation (non-stroke-related)
It can be difficult to figure out where your shoulder pain is coming from, so we highly recommend consulting with your medical team about this.
They can help guide you in the right direction, while this article provides extra support.
Next, we’ll discuss these causes one-by-one and provide treatment options for each.
1. Spasticity – the Most Common Cause for Shoulder Pain
The most common cause of shoulder pain after stroke is spasticity.
Spasticity is muscle tightness caused by the neurological impact of stroke.
Meaning, when stroke damages the part of the brain that controls your shoulder muscles, your shoulder no longer receives messages to relax or contract.
And when your shoulder doesn’t get the message to relax, it won’t!
This stiffness in your shoulder can create shoulder pain.
When you practice something, neuroplasticity is activated and your brain strengthens the neural pathways used during that practice.
To reverse spasticity in your shoulder, you need to practice shoulder rehab exercises. This will strengthen the connections in your brain that control your shoulder.
The stronger this connection becomes, the more your shoulder will relax.
2. Shoulder Subluxation
When the muscles in the shoulder become paralyzed, it can cause the arm to become dislocated from the shoulder socket.
This is called shoulder subluxation and it can be a painful post-stroke condition.
Shoulder subluxation can be treated with very gentle rehab exercise.
You can also use e-stim to help reintroduce movement into paralyzed muscles and get the shoulder to go back into the socket.
In this guide to shoulder subluxation treatment, you’ll also find that shoulder slings can be useful.
However, the more you neglect your shoulder, the more the pain might grow. So only use slings when you really need to.
3. Frozen Shoulder
When shoulder subluxation continues to worsen, it can lead to frozen shoulder.
Frozen shoulder happens when the ligaments in your shoulder socket become stressed and inflamed from the arm “pulling” down on your shoulder.
This can be a painful condition.
Shoulder taping has been found to help relieve pain from frozen shoulder after stroke.
Slings are also known to help some people relieve their shoulder pain after stroke.
Those are just compensation techniques, though.
To solve the root problem, use e-stim and rehab exercise to heal your frozen shoulder.
4. Central Post Stroke Pain
Sometimes shoulder pain has nothing to do with spasticity, shoulder subluxation, or frozen shoulder.
In some cases, shoulder pain is caused by central post stroke pain, a neurological condition that can cause the brain to misinterpret stimulation as pain.
If your pain feels like pins-and-needles or sharp stabbing/searing pain, then it could be central post stroke pain.
Unfortunately, central post stroke pain is hard to treat.
Sometimes painkillers can help, other times they are not effective.
If painkillers don’t help you, then consult with your doctor and ask about your options.
(S)he may refer you to some aggressive chronic pain treatments like deep brain stimulation or spinal cord stimulation.
5. Arthritis and/or Inflammation
Sometimes shoulder pain after stroke isn’t directly caused by stroke.
It’s possible that you developed arthritis or inflammation in your shoulder that’s unrelated to the neurological impact of stroke.
It’s also possible that excessive use of your non-affected shoulder can lead to shoulder pain.
If you think that your shoulder pain is caused by arthritis, talk to your doctor.
(S)he can discuss your treatment options, like medication or surgery.
Relieving Your Shoulder Pain After Stroke
Overall, shoulder pain after stroke often starts with spasticity, and can worsen from there.
Eventually, painful conditions like shoulder subluxation or frozen shoulder can develop.
The best way to treat these conditions is with shoulder rehab exercise that helps the brain reconnect with your shoulder.
As the spasticity goes down, so will the pain.
If spasticity isn’t the culprit, you might be dealing with central post stroke pain or arthritis. Both conditions deserve attention from your doctor.
Do you struggle with shoulder pain after stroke? What do you think the cause is? Please share your story in the comments below!