What is the role of glenohumeral subluxation in the etiology of hemiplegic shoulder pain?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Controversy exists as to whether there is an association between shoulder subluxation and pain. Subluxation has been a commonly cited cause of shoulder pain and disability, with Yu and coauthors reporting that longitudinal data suggests a correlation between early subluxation and shoulder pain. [22, 23] However, Bohannon and colleagues found no significant correlation between the presence of subluxation and the occurrence of pain, [21, 24] while Wanklyn and coauthors found no association between the severity of subluxation and the degree of pain. [25] Numerous cases of subluxation without pain have been documented, as have cases of a painful shoulder without subluxation.

A correlation between subluxation and reflex sympathetic dystrophy (RSD) also has been studied. Dursun and coauthors found that subluxation was present in 74.3% of patients with RSD and in 40% of patients without it; of these same patients, 78.6% with subluxation and 38.1% without subluxation reported shoulder pain. [26] Dursun concluded that shoulder subluxation might be a causative factor of RSD, as well as of shoulder pain.


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