Shoulder-hand Syndrome: Difference between revisions
Essam Ahmed (talk | contribs) (Created page with "Also known as Poststroke complex regional pain syndrome or reflex sympathetic dystrophy of upper limb.") |
Essam Ahmed (talk | contribs) (added physiotherapy section and edited references) |
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'''Original Editor '''- [[User:User Name|Essam Ahmed]] | |||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | |||
</div> | |||
== 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://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. | |||
# Repeated minor trauma from blood drawing and intravenous injections. | |||
# Angio-spasm | |||
# Perceptual deficit | |||
# Central sympathetic dysregulation and neurogenic inflammatory reactions | |||
== Symptoms and Signs == | |||
A definite SHS diagnosis should include the following symptoms<ref name=":4" />: | |||
{| class="wikitable" | |||
|+ | |||
!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 == | |||
The intervention is Multidisciplinary approach that include : | |||
* Medication<ref name=":4" /><ref name=":0" />: NSAID, Oral Corticosteroid, Shoulder Steroid Injection. | |||
* Physical Therapy. | |||
== Physiotherapy == | |||
* [[Mirror Therapy]]<ref name=":4" /><ref name=":0" /> | |||
It is effective in improving sensory-motor function and reducing pain and edema in the upper limb in post-stroke patient. | |||
* [https://www.physio-pedia.com/Orthoses_for_Management_of_Neuromuscular_Impairment?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal Orthoses]<ref name=":3" /> | |||
A functional shoulder orthoses helps prevent and shoulder subluxation in post-stroke patients and reduces the risk of shoulder-hand syndrome. | |||
* [[Acupuncture]]<ref>Peng L, Zhang C, Zhou L, Zuo H, He X, Niu Y. [https://journals.sagepub.com/doi/full/10.1177/0269215517729528?casa_token=rT8OlmHpGcoAAAAA%3ACdBd07incvauc4CKc3s7RfTQWC5vo_1B_hWF-jxS4NzXvaZE2irZZIYtLxuXM7usThuqDFWyEMyp 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.</ref><ref name=":2" /> | |||
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. | |||
* Passive and Active [[Range of Motion|R.O.M]].<ref name=":4" /> | |||
# Maintain R.O.M. and function of the shoulder and hand. | |||
# Reduces pain and edema in the hand. | |||
* [[Low Level Laser Therapy|Laser]]<ref name=":5">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> | |||
Effective in reducing pain and edema in the affected hand and shoulder, improves R.O.M. and Promotes Independency in post-stroke patients. | |||
* [[Transcutaneous Electrical Nerve Stimulation (TENS)|T.E.N.S.]]<ref name=":5" /> | |||
Helps in reducing pain in the affected hand and shoulder and promote R.O.M. | |||
== References == | |||
<references /> | |||
[[Category:Shoulder - Conditions]] | |||
[[Category:Hand - Conditions]] | |||
[[Category:Stroke - Conditions]] | |||
[[Category:Syndromes]] |
Latest revision as of 12:42, 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]
- 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.