Shoulder Hand Syndrome Following Stroke
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Shoulder Hand Syndrome is a relatively common occurrence after very large cerebrovascular accident (stroke). Typically the person has a stroke which leaves them paralyzed on one side. Recovery of the paralysis varies between patients, but often the legs recover quicker then the upper extremity. For some unknown reason, some people are left with significant weakness in the upper extremity that can be quite painful. When the pain is severe in the hand and shoulder on the paralyzed side, the condition is known as Shoulder Hand Syndrome.
Over the past 12 years I have had on several occasions to treat Shoulder Hand Syndrome. Typically the patients came within one year of having a stroke, although I have treated people who waiting longer. Below are a couple of case histories:
A man came to see us with his wife and son. He suffered from a stroke only nine months prior to the visit. The reason for the visit was significant weakness in his left upper extremity, coupled with the fact that he had severe pain in the shoulder and hand on that side. He had excessive internal rotation of the left upper extremity. He had spot tenderness at the anterior shoulder joint. He was given Prolotherapy to his shoulder as well as Prolotherapy and Neural Therapy to his hand and wrist. He was also given a prescription for an electromesh glove (electrical stimulation device for the hand). He was to continue physical therapy.
He had significant pain relief from a total of four Prolotherapy treatments. He was left with some restrictions of motion but overall he was much happier.
A woman came to the office brought by her husband. She felt good except she had severe shoulder and hand pain after a middle cerebral artery stroke. She had point tenderness over the shoulder and wrist. Prolotherapy was given to these areas. She was seen in two weeks at which time the sessions of Prolotherapy were continued. After two sessions her pain was down 50%. She was given a physical therapy prescription at her third visit, as well as Prolotherapy. Prolotherapy overall gave her 90% pain relief.
Prolotherapy in my opinion is one of the best treatments I have found for Shoulder Hand Syndrome. When the pain is diminished or gone the person can better participate in physical therapy. Adjunctive physical therapy and electrical stimulation (electromesh gloves) aid in the healing of the area as well.
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