Article

The assessment and treatment of post-stroke shoulder pain (PSSP) is largely based
on the assumption that pain is due to biomechanical alterations within the
shoulder joint after stroke. However, current treatment often provides limited
pain relief, leading to a considerable number of patients with persistent pain.
This suggests that PSSP may not be merely due to simple nociception from the
shoulder joint. A better understanding of the neurophysiological mechanisms
underlying the development and perpetuation of PSSP is needed. Here, a
theoretical framework for presumed PSSP mechanisms and their assessment is
presented based on key concepts applied in pain research. This theoretical
framework assumes that although pain may be localized in one region of the body,
the mechanisms causing pain may occur at any level of the somatosensory
neuro-axis. Detailed assessment of pain complaints and somatosensory
abnormalities should, therefore, be a key element in clinical PSSP research.
Studies aiming to further characterize somatosensory functions in patients with
PSSP (initially) need to take a broad methodological approach including both
clinical as well as more experimental pain research tools, such as quantitative
sensory testing. A better understanding of pain mechanisms may explain why
persistent PSSP and unsatisfactory pain relief are common despite active
prevention and treatment strategies and may provide a basis for improved clinical
management of PSSP.

Langue : ANGLAIS