Shoulder-hand syndrome and treatment

Shoulder-hand syndrome is a common complication that occurs 1-3 months after recovery from brain injury, with a high incidence of 12.5%-70%. It is characterized by the sudden onset of edema and pain in the affected hand and associated pain in the shoulder joint, resulting in significant limitation of hand function. Because of the pain, contractures may occur, which is an important factor hindering the patient’s recovery. Diseases that cause shoulder-hand syndrome are mostly seen in patients with stroke, including cerebral hemorrhage and cerebral infarction, as well as some paraplegic patients and patients with shoulder joint diseases. Shoulder-hand syndrome can be primary or triggered by other unknown factors. If the syndrome is caused by a minor peripheral nerve injury or central nervous system injury, it is often associated with a primary disease. The prognosis for shoulder-hand syndrome is not very good, with only 1 in 5 patients being able to return to their previous activities, and most being left with a disability. How are such patients cared for? Compressive centripetal wrapping of the fingers with pure wool can reduce swelling, starting at the distal end of the thumb and wrapping around each finger proximally, then wrapping the palm of the hand in the same way up to the joints. Alternatively, ice and water therapy can be used, where ice and water are placed together, with 2/3 of the water, and the affected hand is placed within this, but frostbite and elevated blood pressure should be avoided, which can reduce swelling and analgesia.