Hemiplegic Shoulder Pain Service
Welcome to the Homerton regional Hemiplegic Shoulder Pain (HSP) Service. Here you can find out about our service and our referral form. The HSP clinic assesses patients for their suitability for treatment with steroid injections into or around the shoulder joint with the aim of reducing pain and improving pain-free movement of the shoulder. We can also assess for the presence of muscle overactivity (spasticity) caused by an injury to the brain or spinal cord, and offer treatment for this in the same clinic. We aim to offer a 'one-stop-shop' approach to this common problem.
What do we offer?
We offer steroid injections to the subacromial space, steroid injections into the joint itself and large volume injections to help stretch a tight shoulder joint. We can also assess any muscle overactivity that is contributing to the pain and treat this accordingly with Botulinum Neuro Toxin (BoNT) in the same appointment if it is indicated.
Who can benefit?
People with a neurological diagnosis and shoulder pain with or without joint stiffness or spasticity can be referred into our clinic.
What does an appointment look like?
You will have a comprehensive history taken and be assessed by a consultant physiotherapist who will make a clinical diagnosis. You will then have an X Ray to exclude causes of shoulder pain that cannot be helped by the options available in the clinic. Once this has been completed and reviewed by radiography and the consultant physiotherapist a treatment plan will be agreed with you. This may or may not include injection therapy. If you have a clinical picture that may benefit from injection then this will be discussed with you and the appropriate treatment will be given if you decide it is the right thing for you. Specific risks will be discussed before going ahead with any treatment.
Who is not suitable for treatment?
People with acute fractures of the shoulder
People with bone pain from bone infarcts (acute avascular necrosis)
people with active infection of the shoulder joint
People taking some types of antiretroviral medications due to drug interactions
People allergic to local anaesthetic or steroid medication
Considerations for referrers
Some people will not be suitable for some of the interventions we offer if they are taking anticoagulant medication such as warfarin, however this should not stop a referral as some of our other treatment options may be suitable.
Steroid medication can interfere with blood sugar control for up to 2 weeks after injection. Patients should have a plan to ensure glucose control after injection
How do I refer?
Please refer on the Shoulder Pain referral form and email to huh-tr.shoulderpain@nhs.net
How can I contact the team?
Please use our service specific email address: huh-tr.shoulderpain@nhs.net This is checked regularly but not daily.