Shoulder Pain

Why does it happen

Shoulder pain after a stroke is caused by weak or tight shoulder muscles.

The bones in your shoulder are held together with muscles. This is different from other parts of the body held together by strong ligaments.

Shoulder pain caused by weak muscles:

When your shoulder muscles are weak or limp, the weight of your arm causes your shoulder joint to pull apart. This is called shoulder subluxation. The pulling on the joint causes pain.

How can I manage it?

If you have weak shoulder muscles, you may need to support your arm. Speak to your physiotherapist or occupational therapy to find the best strategy for you.

You may need to use a:

special sling to support your arm (not a triangle sling)
shoulder bag
your jacket or pants pocket
an arm support for a wheelchair

Should pain caused by tight muscles:

When your shoulder muscles are tight, they pull your shoulder joint in too close. This is called tone. This also makes your shoulder stiff and hard to move.

How can I manage it?

If you have tight shoulder muscles, you
can talk to a physiotherapist to learn how
to stretch and position your arm correctly. You may also need a doctor to refer you to a spasticity clinic.

The specialists at a spasticity clinic can
help:

prescribe muscle relaxing medicines
teach you exercises to help you move more easily

Some people have weak or tight muscles in other parts of the body too. This could also be painful. Some other place you may have pain are:

Elbow
Hand
Leg
Foot

Below are examples of how how a bag and arm tray can support your arm.

The following video offers tips on how to support your shoulder to reduce or avoid shoulder pain.

Video credit: Lakeridge Health

If you have tight shoulder muscles, you may need to go to a spasticity clinic.

At the clinic, the specialists can help:

Prescribe some muscle relaxing medicines
Teach you some exercises to help you move more easily

The clinic team may include a:

Physiatrist (a doctor who specializes in rehabilitation medicine)
Neurologist (a doctor who specializes in the brain)
Nurse
Physiotherapist
Occupational therapist
Kinesiologist

How do I get an appointment at a spasticity clinic?

Ask your doctor for a referral.

Do I need to pay for the spasticity clinic?

You do not need to pay for the clinic service. If you need medicines, you will need to pay for this. If you have private health insurance, they may pay for your medicines. Check with your insurance company.

Having read the information in this section, consider the following

Do I have tightness or weakness in my muscles that is causing pain or limiting my movement?
Does pain limit or stop me from doing the things I want to do?
Do I know what to do if my pain gets worse, is more frequent, or lasts longer?
Do I know what to do if my pain is causing other problems (for example: anxiety, memory problems, sleep issues)?