What should I do if my shoulders are stiff and inflexible after a stroke? What medicine is the most effective?
After a stroke, one's shoulder would be stiff and inflexible. One could treat it from the following aspects: 1. ** In terms of rehabilitation training ** - ** Correct positioning and transfer **: Pay attention to the correct position of the affected limb during the acute stage of paralysis. In the healthy side lying position, rest your head on the pillow, do not turn back, the torso is roughly vertical to the bed surface, the upper limb of the affected side is propped up with a pillow, the elbow is bent forward, the lower limb of the affected side is kept in a bent hip and knee position, and the foot is not suspended in the air; In the affected side lying position, rest your head on the pillow, the torso is tilted back to avoid direct compression of the affected side, the shoulder is bent forward, the elbow is extended, the forearm is rotated back, the palm of the hand is upward, the fingers are extended, the hip of the affected side is extended, and the knee is slightly bent; In the supine position, place the head on the pillow. Do not bend and stretch too much. The shoulder of the affected side is propped up and the shoulder is slightly extended. The elbow, wrist and fingers of the affected side are stretched on the pillow with the palm facing up. The outer side of the affected leg is supported by a pillow to prevent external rotation. The knee is slightly bent. When sitting in a wheelchair, sit up straight with the pillow on the back. Put the affected hand on the armrest or leg of the wheelchair. Support it with the pillow. Spread your feet and put your toes forward. - ** Patient's autonomous movement **: The patient can learn to extend the upper limbs forward to ensure that the scapula is extended forward, then extend the elbow and cross the fingers of both hands.(Place the affected finger above the healthy finger), use the healthy hand to move the paralyzed arm up to exercise the shoulder joint; when sitting, hold both hands on the big ball, lean forward to push the ball and then return.(The actual movement occurs on the hip joint, and the shoulder joint is raised further. If there is pain, move back); Do the active or passive abduction of the shoulder joint to stimulate the shoulder muscles; Do the shoulder blade retracting movement (the elbow is clamped on both sides of the body, the forearm is in a neutral position, the thumb is up, and the forearm is rotated outward but not shrugged until there is pressure on the inside of the shoulder blade. If the affected side cannot complete it independently, the healthy side can move it). When shoulder pain occurs, the shoulder movement should be done by moving the scapula and shoulder from the near end, such as shrugging. - ** Prevented shoulder subluxation **: Since the shoulder joint relies on the surrounding muscles and tendons to maintain stability, muscle weakness in the early stage of paralysis will lead to shoulder subluxation. Wearing the shoulder brace correctly can increase the stability of the glenohumerus joint and reduce shoulder pain in the later stage. 2. ** In terms of auxiliary treatment ** - ** Kinesiology Patches **: Use the elasticity of the tape to apply the tension to the sticking part to achieve detumescence, pain relief, strengthening muscle relaxation, correcting joint movements, etc. It has a correcting effect on the round shoulder and the internal and external rotation of the humerus head after stroke to prevent shoulder pain. - ** Arm loosening technique **: It is operated by a professional healer. After relaxing the muscles around the shoulder, the scapula and glenohumerus joint will be loosened. Treatment will be performed for the causes such as immobility, abnormal movements in the joint, and spasm of the muscles around the shoulder. In terms of medication, shoulder stiffness and pain after a stroke can be relieved by taking the following drugs as prescribed by the doctor: 1. ** Ibuprofen **: It can be used to relieve mild to moderate pain caused by stroke sequelae. It has antipyretic, painkiller, and anti-inflammatory effects. However, there may be discomfort in the digestive tract when taking it. Long-term use requires monitoring of kidney function. 2. ** Paracetomol **: It is suitable for the treatment of fever and mild to moderate pain in stroke patients. It can suppress the synthesis of progestins to reduce fever and relieve pain. It should be used with caution in patients with liver failure. It is not advisable to drink alcohol during medication. 3. ** Diclofenac Na **: It can relieve the persistent pain caused by muscle tension and stiffness in the shoulder after stroke. It is a non-steroid anti-inflammatory drug that can suppress the activity of epoxidizing acid and block the conversion of arachidonic acid to prostanoids to play a role in antipyretic, pain-relieving, and anti-rheumatism. It should be reduced in dosage for patients with kidney deficiency. Long-term use of large quantities of it in the elderly will cause bone thinning. 4. [Mescitrade]: It can be used for local pain caused by soft tissue sticking and contracture around the shoulder joint caused by stroke sequelae. It is a patch for external use. The main ingredients are chelidonine, belladona extract, and chili fluid extract. It has the effect of reducing swelling and relieving pain. However, it is forbidden to use the patch on skin ruptures. Do not place the patch in direct sunlight or high temperature. 5. ** Piroxican **: It is effective for the pain caused by the sequelae of stroke. It is a non-steroid anti-inflammatory drug with strong anti-inflammatory and painkiller effects. It should be reduced in patients with kidney failure. It is prohibited for patients with severe kidney damage. Long-term use of large amounts of it in the elderly will cause bone loss. It should be noted that all drugs should be used reasonably according to the doctor's advice. Read more exciting novels for free
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