What is the role of triamcinolone acetonide injections in the treatment 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

The injection of triamcinolone acetonide into the glenohumeral joint has been used to relieve shoulder pain experienced by patients with hemiplegia. Typically, 3 injections of 40 mg of triamcinolone are given via the posterior route. [48]

Dekker and colleagues demonstrated significant reduction in pain (5 of 7 patients) and improved ROM (4 of 7 patients) that did not reach a level of significance. [49] None of the secondary outcome parameters (eg, spasticity, motor function, signs and symptoms of shoulder-hand syndrome) showed statistically significant changes either. Dekker concluded that careful positioning, adequate support, and proper handling remain the key actions to prevent hemiplegic shoulder pain.

Another study, a randomized placebo-controlled trial by Snels and coauthors involving intra-articular triamcinolone injections, concluded that treatment effect seemed to decrease shoulder pain and accelerate recovery but was also not found to be statistically significant when compared with placebo. [35]


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