title: Does hemiplegic shoulder pain share clinical and sensory characteristics with central neuropathic pain? A comparative study.
abstract: BACKGROUND
  Hemiplegic shoulder pain (HSP) is a common poststroke complication and is considered to be a chronic pain syndrome. It is negatively correlated with the functional recovery of the affected arm and the quality of life of the individual. It also leads to a longer length of stay in rehabilitation. Today, there is no consensus as to the underlying mechanism causing HSP, making the syndrome difficult to treat.
  
  
  OBJECTIVE
  The aim of this study was to compare the clinical and sensory profile of individuals with HSP to that of individuals with established central neuropathic pain (CNP) in order to identify common features and the presence of neuropathic components in HSP.
  
  
  METHODS
  Cross sectional controlled study.
  
  
  METHODS
  Outpatient rehabilitation clinics.
  
  
  METHODS
  Sixteen chronic HSP patients and 18 chronic CNP patients with spinal cord injury (SCI-CNP).
  
  
  METHODS
  The chronic pain characteristics, thresholds of thermal and tactile sensations and presence of pathological sensations were compared between groups, and between painful and pain free body regions within groups. Correlations were calculated between HSP intensity and sensory and musculoskeletal characteristics.
  
  
  RESULTS
  Patients with HSP and patients with SCI-CNP had similar decrease of thermal sensibility in the painful compared to intact body regions and both groups presented similar rates of pathological sensations in painful regions. HSP and SCI-CNP differed however, in the quality of pain and aggravating factors. Significant correlations were found between HSP intensity and heat-pain threshold, presence of subluxation and spasticity.
  
  
  CONCLUSIONS
  The similarities between HSP and SCI-CNP and the altered spinothalamic function and sensitization suggest that HSP has neuropathic components in its mechanism. Nevertheless, the unique features of HSP point towards additional possible mechanisms.
  
  
  CONCLUSIONS
  The use of specific therapy options for neuropathic pain should be considered when treating patients with HSP.
authors.affiliation: Department of Neurological Rehabilitation, Sheba Medical Center, Tel-Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel - Gabi.Zeilig@sheba.health.gov.il.
authors.forename: Gabi
authors.initials: G
authors.lastname: Zeilig
authors.forename: Michal
authors.initials: M
authors.lastname: Rivel
authors.forename: Dana
authors.initials: D
authors.lastname: Doron
authors.forename: Ruth
authors.initials: R
authors.lastname: Defrin
mesh_terms: D000368:Aged; D059350:Chronic Pain / Q000534:rehabilitation; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017288:Pain Threshold; D018570:Risk Assessment; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome