Shoulder pain in tetraplegia

The effects of shoulder pain and the outcomes of treatments for shoulder pain are of great consequence to the person with tetraplegia, as the shoulder is one of the few functioning regions following spinal cord injury. Shoulder pain is common in tetraplegia. Following cervical spinal cord injury many people experience severe shoulder pain and stiffness, which although frequently seen, is poorly understood. People with long-standing cervical spinal cord injury may experience shoulder pain due to a wide range of pathologies that may relate to overuse or overload of the shoulder.Clinical examination and investigation of the tetraplegic shoulder are similar to evaluation and investigation of the shoulder in ambulant patients. It is also important to consider other factors in the assessment of the tetraplegic shoulder, including wheelchair type, ergonomics and environment. Individual factors include transferring technique, patterns of use and posture, patterns of weakness and stiffness. Treatments commonly include physiotherapy, modifications in environmental factors, sometimes injections and occasionally surgery. If surgery is undertaken, it is important to plan for a period of increased dependence during the recovery stage and optimal to have the support of a spinal injuries rehabilitation unit.