Causes of the Hemiplegic Shoulder Pain

Objective: To find out how many causes constitute hemiplegic shoulder pain (HSP) and how they distribute in an individual patient. Method: Twenty-three consecutive patients with HSP which had newly developed within 3 months after stroke were enrolled from January 2008 till July, 2008. They all performed a passive range of motion test for adhesive capsulitis, modified Ashworth test for spasticity, simple x-ray for subluxation, ultrasonography for rotator cuff problems and three-phase bone scintigraphy for complex regional pain syndrome (CRPS). The causes of HSP were analyzed in number and distribution. Results: Average 2.26 causes constituted with HSP in an individual patient. Most common causes were adhesive capsulitis and CRPS (respectively 14 patients). Two patients had 4 and eight patients had 3 types of shoulder pathology. Conclusion: More than two types of shoulder pathology existed in a patient with HSP. These findings shoulde be carefully considered when treating the patients with HSP.