Shoulder pain


What causes shoulder pain?

Shoulder pain after a stroke is caused by weak or tight shoulder muscles.

Normal shoulder position

The bones in your shoulder are held together with muscles. This is different from other parts of the body held together by strong ligaments

When your shoulder muscles are weak or limp, the weight of your arm causes your shoulder joint to pull apart. This is called shoulder subluxation. The pulling on the joint causes pain. 

When your shoulder muscles are tight, they pull your shoulder joint in too close. This is called spasticity. This also makes your shoulder stiff and hard to move. 

Some people have weak or tight muscles in other parts of the body too. This could also be painful.

Some other place you may have pain are:

  • Elbow
  • Hand
  • Leg
  • Foot


How can I manage my shoulder pain?

If you have shoulder pain, talk to your physiotherapist or occupational therapist. There are things you can do to manage the pain.

If you have weak shoulder muscles, you may need to support your arm.

For example, you may need to use a:

  • Special sling
  • Shoulder bag
  • Jacket pocket
  • Pant pocket

If you are using a wheelchair, you may need a tray to support your arm.

Shoulder bag

Arm tray


If you have tight shoulder muscles, you may need to go to a spasticity clinic. 

At the clinic, the specialists can help:

  • Prescribe some muscle relaxing medicines
  • Teach you some exercises to help you move more easily

The clinic team may include a:

  • Physiatrist (a doctor who specializes in rehabilitation medicine)
  • Neurologist (a doctor who specializes in the brain) 
  • Nurse
  • Physiotherapist
  • Occupational therapist
  • Kinesiologist


How do I get an appointment at a spasticity clinic?

Ask your doctor for a referral.


Do I need to pay for the spasticity clinic?

You do not need to pay for the clinic service. If you need medicines, you will need to pay for this. If you have private health insurance, they may pay for your medicines. Check with your insurance company.

Video credit: Lakeridge Health

Where to learn more about this topic:  

Toronto Rehabilitation Institute, UHN

Spasticity Management Clinic


West Park Healthcare Centre

Spasticity Management Clinic