• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • General Ortho
  • Procedures
  • Spine
  • Upper Limb
  • Lower Limb
  • Pain
  • Trauma
  • Tumors
  • Newsletter/Updates
  • About Us
  • Contact Us

Bone and Spine

Orthopedic health, conditions and treatment

Shoulder Hand Syndrome

By Dr Arun Pal Singh

In this article
    • Diagnosis of Shoulder Hand Syndrome
    • Imaging in Shoulder Hand Syndrome
    • Treatment of Shoulder Hand Syndrome

Complex regional pain syndrome of upper limbs after stroke is frequently called shoulder-hand syndrome (SHS). Complex regional pain syndrome is neuropathic pain disorders that develop as an exaggerated response to a traumatic lesion or nerve damage or as the consequence of a distant process such as a stroke, spinal lesion or myocardial infarction.

However, sometimes it may appear without an apparent cause.

The onset and severity of shoulder-hand syndrome appear to be related with the cause of the stroke, the severity, and recovery of motor deficit, spasticity, and sensory disturbances.

Another important aetiological factor is glenohumeral subluxation. The physiopathology of the disease is still not known.

In CRPS, there is an exaggerated inflammatory response and some chemical mediators have been identified and are present in the inflammatory soup around the primary afferent fibers that, through different processes, can induce hyperexcitability of the afferent fibers. It is hypothesized that a localized neurogenic inflammation is at the basis of edema, vasodilation, and hyperhidrosis that is present in the initial phases of CRPS. The repeated discharge of the C fibers causes an increased medullary excitability (central sensitization). Another important factor is the reorganization of the central nervous system, and in particular, this appears to affect the primary somatosensory cortex

Diagnosis of Shoulder Hand Syndrome

There would be a history of stroke and the paretic upper arm frequently appears painful, swollen, with altered heat and tactile sensations and slightly dystrophic skin within a non-use syndrome.

Diagnosis is clinical and there are no specific tests, nor pathognomic symptoms to identify this disease with certainty.

Imaging in Shoulder Hand Syndrome

Imaging is noncontributory. However, some investigations can aid differential diagnosis with other diseases.

Treatment of Shoulder Hand Syndrome

Treatment may be consists of psychotherapy, regional anesthesia, neuromodulation, and sympathectomy.

A variety of drugs are used to treat shoulder hand syndrome which includes antidepressants, anti-inflammatory drugs,  vasodilators, GABA analogs such as gabapentin and pregabalin, and alpha- or beta-blockers, and opioid analgesics.

The key to effective treatment undoubtedly lies in an expert multidisciplinary team.

Spread the Knowledge
  • 11
    Shares
  •  
    11
    Shares
  •  
  • 11
  •  
  •  
  •  

Filed Under: Hand and Upper Limb

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Primary Sidebar

Wound debridment becomes necessary in such cases

Different Types of Wound Debridement

Wound debridement or debridement is the process of removing infected, damaged, dead, nonviable tissue or foreign matter wounds so as to improve the healing potential of the remaining healthy tissue. Wound debridement can be achieved with surgery or by nonsurgical means. Why Wound Debridement is Done? A wound that contains tissue which is dead or […]

Degrees of freedom Knee

Normal Biomechanics of Knee and Movements

Knee allows locomotion with minimum energy requirements from the muscles and stability for accommodating for different terrains. The knee joint has biomechanical roles in allowing gait by flexing and rotating and at the same time, provides stability during the activities of daily life. It shortens and extends lower limb as required and transmits forces across […]

RICE therapy

RICE Therapy – Rest, Ice, Compression, Elevation

RICE stands for Rest, Ice, Compression and Elevation. These four indicates measures taken in the acute setting of injury. The purpose of RICE therapy is to reduce pain, bleeding and ultimately swelling. Too much swelling interferes with healing [Body has to work to reduce swelling in addition to the original healing process], can lead to […]

Leg Length Measurement with Tape

True and Apparent Leg Length Measurement

True and apparent leg length refer to limb lengths in absolute terms and in compensated forms. The limb length measurement is used to find leg length discrepancy if any. When there is a shortening of the limb, the body compensates by tilting the pelvis down, equinus position of the foot and flexion of the opposite […]

Brachial Plexus Injury

Brachial Plexus Injury – Causes, Presentation and Treatment

Brachial plexus injuries can occur in neonates following birth trauma [Erb’s paralysis and Klumpke’s paralysis], compression of brachial plexus by surrounding structures [thoracic outlet syndrome] and due to inflammation of the nerve [Turner parsonage syndrome or brachial neuritis] and direct or indirect injury by trauma [called traumatic brachial plexus injury]. Traumatic brachial plexus is the […]

Stress fracture of second metatarsal

Stress Fracture -Causes, Locations, Symptoms and Treatment

Stress fracture is a is caused by fatigue of the bone due to repeated stress on the bone over a period. In contrast to fractures occuring as a single event of force acting to cause breakage of the bone, stress fractures result from accumulated trauma. The bone over a period then fails and fracture results. […]

qCT or quantitative computed tomography vertebra

Quantitative computed tomography or QCT

Quantitative computed tomography is a procedure which uses CT scan for quantitative assessment of the bones or bone mineral density. It is mainly used in osteoporotic patients.  By Osteoporosis is a skeletal disease, characterized by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. […]

Browse Articles

Footer

Pages

  • About
    • Policies
    • Contact Us

Featured Article

Radiofrequency Chondroplasty

Radiofrequency chondroplasty is a technique where heat is used to remove the unstable edges of the defect producing a smooth, stable articular … [Read More...] about Radiofrequency Chondroplasty

Search Articles

© Copyright: BoneAndSpine.com