Hemiplegic Shoulder Pain: A Narrative Review

Authors

Yeh-Kai Liao, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
Chueh-Hung Wu, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, TaiwanFollow
Levent Özçakar, Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey

Abstract

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity laser therapy and repetitive transcranial magnetic stimulation are promising; however, large-scale trials are needed to confirm their efficacy.

Recommended Citation

Liao, Yeh-Kai; Wu, Chueh-Hung; and Özçakar, Levent (2025) "Hemiplegic Shoulder Pain: A Narrative Review," Rehabilitation Practice and Science: Vol. 2025: Iss. 1, Article 1.
DOI: https://doi.org/10.6315/3005-3846.2247
Available at: https://rps.researchcommons.org/journal/vol2025/iss1/1