Subacromial Corticosteroid Injection for Hemiplegic Shoulder Pain


Phase 2 Results

Eligibility Criteria

Inclusion Criteria

- Age greater than 18
- upper extremity hemiplegia due to hemorrhagic or nonhemorrhagic stroke
- ≤ 4/5 on manual muscle testing for the deltoid on the affected side if isolated movement is present
- post-stroke duration ≥ 1-mo, but < 24-mo
- shoulder pain sustained for ≥ 1-mo
- BPI 12 ≥ 4 (pain scale)
- willing and able to report pain and other conditions throughout the 4-mo study period
- positive Neer's test

Exclusion Criteria

- evidence of joint or overlying skin infection
- > 2 opioid and/or nonopioid analgesic for shoulder pain (i.e., > 2 regardless of class)
- regular intake of pain medications for any other chronic pain
- steroid injections to the shoulder in the last 6-wks
- history of pre-stroke shoulder pain
- bleeding disorder
- for those on Coumadin, INR > 3.0
- history of allergies to lidocaine
- renal insufficiency (Creat > 2.0)
- both history of liver disease & abnormal liver enzyme lab results
- poorly controlled diabetes (HbA1c > 7.0)
- medical instability
- cognitive deficits; In order to pass the cognitive exam, the participant must exhibit 3/3 registration and recall the same three objects in 30 minutes. The participant must also be able to correctly rank the following three levels of pain from highest to lowest: 1) falling from a 2-story building and breaking both ankles, 2) stubbing one's toe and 3) getting bitten by a mosquito.
- immunocompromised