2025 Volume 62 Issue 9 Pages 943-950
Objective: Shoulder pain, which is common in hemiplegic stroke patients, decreases quality of life and interferes with rehabilitation. Although many local injection therapies have been reported for shoulder pain in hemiplegic stroke patients, that to the coracohumeral ligament has not been reported. In a stroke paraplegic patient with shoulder pain, we evaluated the effect of local steroid injection therapy on pain, sleep and range of movement.
Methods: Among stroke hemiplegia patients with shoulder pain admitted to our rehabilitation department, 14 shoulders with inadequate pain control by joint range of motion training, anatomical restoration, and analgesic medication were included in this study. Local steroid injections were performed on the coracohumeral ligament under ultrasound guidance. The evaluation items were pain during movement, nocturnal pain, sleep disturbance, and changes in shoulder joint range of motion (flexion, abduction, and external rotation in the pronated position). The Athens Insomnia Scale score was used to assess sleep disturbance. Each item was evaluated before injection, 2 weeks after injection, and 4 weeks after injection.
Results: Pain during movement 4 weeks after injection, nocturnal pain and Athens Insomnia Scale score 2 and 4 weeks after injection improved significantly. The range of motion of the shoulder joint was also significantly improved in flexion 2 weeks after injection and in external rotation after 4 weeks of injection.
Conclusion: Local steroid injections into the coracohumeral ligament may be one treatment option to reduce shoulder pain in stroke hemiplegic patients, as it significantly reduced pain during movement and nighttime pain and sleep disturbances.
