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Hemiplegic shoulder pain — DGM MCQ

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HardStroke and rehabilitationHemiplegic shoulder painDGM

An 79-year-old man 4 weeks after stroke has shoulder pain, reduced passive external rotation and subluxation. He has poor arm movement and cannot dress. X-ray shows no fracture and inflammatory markers are normal. What is the most appropriate management?

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Correct answer: D — Physiotherapy and occupational therapy with shoulder positioning and pain management

Hemiplegic shoulder pain needs careful handling, positioning, pain control and therapy input. Forceful stretching can worsen injury, and prolonged unsupported immobilisation may increase stiffness and neglect. Shoulder pain can significantly impede stroke rehabilitation.

Reference: NICE NG236