Shoulder pain is the most common complication of post-stroke, which occur up to 60% patients with post-stroke. The aim of our research is to study the effect botulinum toxin type A and triamcinolone for shoulder pain on patients with post-stroke.

Seventy-five patients with shoulder pain on post-stroke patients were randomly divided into three groups based on difference of injection (A:BoNT-A, B: triamcinolone, C: saline). Each group was injected once with ultrasound guidance. All groups received therapeutic exercise up to 4 weeks. The Evaluation of Fugl-Meyer assessment (FMA), Visual Analogue Scale (VAS) and pain-free range of motion (ROM) were recorded for pain and quality of life at baseline and end of 4th week after injection.

The FMA of upper-limb were significantly improved in group A and group B patients between baseline and end of 4th week (P<.05). The VAS score in group A and group B significantly decreased from 6.9±1.1 (baseline) to 2.7±1.4, and from 6.3±1.2 (baseline) to 4.4±1.2 at 4 weeks (P<.05) respectively. The passive ROM and active ROM were significantly improved in group A and group B patients between baseline and 4 weeks (P<.05). The between-group comparison revealed significant differences in group A and group B, group B and group C with regard to the FMA of upper-limb, VAS score and ROM at 4 weeks (P<.05). No changes were observed for the group C after intervention. No adverse events were occurred in all group patients.

The all treatments can significantly reduce shoulder pain and recovery function in patients with stroke, but BoNT-A combined with physical therapy seems to affect better for such patients.