Shoulder-hand Syndrome
Original Editor - Essam Ahmed
Top Contributors - Essam Ahmed
Definition and Causes[edit | edit source]
Also known as Post-stroke complex regional pain syndrome or reflex sympathetic dystrophy of upper limb[1]. Shoulder-hand Syndrome (SHS) is a multifactorial disorder[2]characterized by edema and swelling of the hand, hyperalgesia, sever pain and loss of function in the shoulder joint with changes in the skin color and temperature[3][4].The cause is still unknown, but it may be due to one or multiple causes which include[2][5]
- Prolonged immobility.
- Repeated minor trauma from blood drawing and intravenous injections.
- Angio-spasm
- Perceptual deficit
- Central sympathetic dysregulation and neurogenic inflammatory reactions
Symptoms and Signs[edit | edit source]
A definite SHS diagnosis should include the following symptoms[5]:
Site | Symptoms and Signs |
---|---|
Shoulder | Loss of ROM; pain and tenderness elicited by these motions or in rest |
Elbow | Usually no symptoms |
Wrist | Considerable pain on extension; tenderness to deep palpation and dorsal oedema over carpal bones |
Hand | little pain or tenderness; oedema overlying metacarpals |
Digits | Considerable pain on flexion of metacarpal-phalangeal and interphalangeal joints; moderate oedema and loss of dorsal skin lines; changes in hair and nail growth; vasomotor and changes in temperatute, colour and hidrosis |
Interventions[edit | edit source]
The intervention is Multidisciplinary approach that include :
Physiotherapy[edit | edit source]
It is effective in improving sensory-motor function and reducing pain and edema in the upper limb in post-stroke patient.
A functional shoulder orthoses helps prevent and shoulder subluxation in post-stroke patients and reduces the risk of shoulder-hand syndrome.
Combined with a rehabilitation program, Acupuncture helps reduce the pain, Improves upper limb function and the activity of daily living compared with rehabilitation program alone.
- Maintain R.O.M. and function of the shoulder and hand.
- Reduces pain and edema in the hand.
Effective in reducing pain and edema in the affected hand and shoulder, improves R.O.M. and Promotes Independency in post-stroke patients.
Helps in reducing pain in the affected hand and shoulder and promote R.O.M.
References[edit | edit source]
- ↑ 1.0 1.1 1.2 Saha S, Sur M, Ray Chaudhuri G, Agarwal S. Effects of mirror therapy on oedema, pain and functional activities in patients with poststroke shoulder‐hand syndrome: A randomized controlled trial. Physiotherapy Research International. 2021;26(3).
- ↑ 2.0 2.1 Kondo I, Hosokawa K, Soma M, Iwata M, Maltais D. Protocol to prevent shoulder-hand syndrome after stroke. Archives of Physical Medicine and Rehabilitation. 2001;82(11):1619-1623.
- ↑ 3.0 3.1 Liu S, Zhang C, Cai Y, Guo X, Zhang A, Xue C et al. Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis. Frontiers in Neurology. 2019;10.
- ↑ 4.0 4.1 Hartwig M, Gelbrich G, Griewing B. Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder–hand syndrome: a randomized clinical trial. Clinical Rehabilitation. 2012;26(9):807-816.
- ↑ 5.0 5.1 5.2 5.3 5.4 C. H Geurts, B. A. J. T. Visschers, A. Systematic review of aetiology and treatment of post-stroke hand oedema and shoulder-hand syndrome. Scandinavian Journal of Rehabilitation Medicine. 2000;32(1):4-10.
- ↑ Peng L, Zhang C, Zhou L, Zuo H, He X, Niu Y. Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis. Clinical Rehabilitation. 2017;32(4):429-439.
- ↑ 7.0 7.1 Karabegović A, Kapidžić-Duraković S, Ljuca F. Laser Therapy of Painful Shoulder and Shoulder-Hand Syndrome in Treatment of Patients after the Stroke. Bosnian Journal of Basic Medical Sciences. 2009;9(1):59-65.