Shoulder-hand Syndrome: Difference between revisions

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== Definition and Causes ==
== Definition and Causes ==
Also known as Post-[[stroke]] [https://www.physio-pedia.com/index.php?title=Complex_Regional_Pain_Syndrome_(CRPS)&redirect=no%3Futm_source%3Dphysiopedia&utm_medium=search&utm_campaign=ongoing_internal complex regional pain syndrome] or reflex sympathetic dystrophy of upper limb<ref name=":0">Saha S, Sur M, Ray Chaudhuri G, Agarwal S. [https://onlinelibrary.wiley.com/doi/full/10.1002/pri.1902 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).</ref>. Shoulder-hand Syndrome (SHS) is a multifactorial disorder<ref name=":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.</ref>characterized by edema and swelling of the hand, hyperalgesia,  sever pain and loss of function in the [https://www.physio-pedia.com/Shoulder?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal shoulder joint] with changes in the skin color and temperature<ref name=":2">Liu S, Zhang C, Cai Y, Guo X, Zhang A, Xue C et al. [https://www.frontiersin.org/articles/10.3389/fneur.2019.00433/full Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis]. Frontiers in Neurology. 2019;10.</ref><ref name=":3">Hartwig M, Gelbrich G, Griewing B. [https://journals.sagepub.com/doi/full/10.1177/0269215511432355?casa_token=cYzPfyqVvbQAAAAA%3AipgyKXBqUmls2tURHIiJTAMz4EAXX1kSI56xZIsqItd-Rsyb6KwdIuv5kCG4Q1ikraaXlHgFMEOr 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.</ref>.The cause is still unknown, but it may be due to one or multiple causes which include<ref name=":1" /><ref name=":4">C. H Geurts, B. A. J. T. Visschers, A. [https://d1wqtxts1xzle7.cloudfront.net/42079037/Systematic_review_of_aetiology_and_treat20160204-30232-1wm564w-with-cover-page-v2.pdf?Expires=1650801804&Signature=NPuStHKJGl84SQz6jT1GKT-qeLpC5n7EZkgCNpy5NTChRTYAdHu3kitrKHkqDM3QvgfETcceOyMutdFh4WBQMzbwBRaS1eEDCQI2dRxZUTaB8HKFP9EiDmKzRc8aK279aJARc4lDA2bkXO3TTNnUesyZFEKUwk~C5PayrcYZn9WJ8eZ68dWIbOHeaJOisHWf1GcxWj3X~w75nvUBDDoThiFCqukykRP27UJJZUOE56zpOze4nrMHfhiD-I2D-fP3QIfnJ8BWIMzjLUX7AFZqE-EQ-JCbP5jL-~voqSO3gGmxtLYLaKZybEselG97OFj2Lu-IqK~-2k532P-NAzivbA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA 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.</ref>
Also known as Post-[[stroke]] [https://www.physio-pedia.com/index.php?title=Complex_Regional_Pain_Syndrome_(CRPS)&redirect=no%3Futm_source%3Dphysiopedia&utm_medium=search&utm_campaign=ongoing_internal complex regional pain syndrome] or reflex sympathetic dystrophy of upper limb<ref name=":0">Saha S, Sur M, Ray Chaudhuri G, Agarwal S. [https://onlinelibrary.wiley.com/doi/full/10.1002/pri.1902 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).</ref>. Shoulder-hand Syndrome (SHS) is a multifactorial disorder<ref name=":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.</ref>characterized by edema and swelling of the hand, hyperalgesia,  sever pain and loss of function in the [https://www.physio-pedia.com/Shoulder?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal shoulder joint] with changes in the skin color and temperature<ref name=":2">Liu S, Zhang C, Cai Y, Guo X, Zhang A, Xue C et al. [https://www.frontiersin.org/articles/10.3389/fneur.2019.00433/full Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis]. Frontiers in Neurology. 2019;10.</ref><ref name=":3">Hartwig M, Gelbrich G, Griewing B. [https://journals.sagepub.com/doi/full/10.1177/0269215511432355?casa_token=cYzPfyqVvbQAAAAA%3AipgyKXBqUmls2tURHIiJTAMz4EAXX1kSI56xZIsqItd-Rsyb6KwdIuv5kCG4Q1ikraaXlHgFMEOr 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.</ref>.The cause is still unknown, but it may be due to one or multiple causes which include<ref name=":1" /><ref name=":4">C. H Geurts, B. A. J. T. Visschers, A. [https://www.researchgate.net/publication/12533710_Systematic_review_of_aetiology_and_treatment_of_post-stroke_hand_oedema_and_shoulder-hand_syndrome 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.</ref>


# Prolonged immobility.
# Prolonged immobility.
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# [[Low Level Laser Therapy|Laser]]<ref>Karabegović A, Kapidžić-Duraković S, Ljuca F. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645550/ 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.</ref>
# [[Low Level Laser Therapy|Laser]]<ref>Karabegović A, Kapidžić-Duraković S, Ljuca F. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645550/ 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.</ref>
# [[Transcutaneous Electrical Nerve Stimulation (TENS)|T.E.N.S.]]<ref name=":4" />
# [[Transcutaneous Electrical Nerve Stimulation (TENS)|T.E.N.S.]]<ref name=":4" />
== Physical Therapy ==
# Mirror Therapy:


== References  ==
== References  ==

Revision as of 00:44, 2 May 2022

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]

  1. Prolonged immobility.
  1. Repeated minor trauma from blood drawing and intravenous injections.
  2. Angio-spasm
  3. Perceptual deficit
  4. 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

Treatment[edit | edit source]

The Treatment is Multidisciplinary approach that include :

  • Medication[5][1]: NSAID, Oral Corticosteroid, Shoulder Steroid Injection.
  • Physical Therapy which includes:
  1. Mirror Therapy[5][1]
  2. Orthoses[4]
  3. Acupuncture[6][3]
  4. Passive and Active R.O.M.[5]
  5. Laser[7]
  6. T.E.N.S.[5]

References[edit | edit source]

  1. ↑ 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. ↑ 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. ↑ 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. ↑ 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. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 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.
  6. ↑ 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. ↑ 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.
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