The Use of Hyaluronic Acid for Hemiplegic Shoulder Pain

Hemiplegic shoulder pain is a common phenomenon that occurs in patients who experience a stroke and it is characterized with impaired hand movement and function. Hyaluronic acid, a naturally occurring compound in the human body belonging to a group of compounds called glycosaminoglycans has been effectively used for relieving hemiplegic shoulder pain in the form of injections. It is found in the synovial fluid of the joints where it is used to provide lubrication and allow for soft tissue movement.

Mechanism of action of hyaluronic acid injections in relieving hemiplegic shoulder pain is mediated by its ability to bind unto immune cell receptors activating them that which in turn release various immune responses and together help in eliminating the pain. The various mechanisms include;

•Inhibiting inflammation

Hyaluronic acid is able to bind to CD44 immune receptors causing the immune cells to reduce the levels of inflammatory mediators in the synovial fluid and by forming a barrier of inflammatory cells thus inhibiting their movement into the area associated with pain.

•Analgesic effect

Once injected, hyaluronic acid is able to form a protective coating over the synovial joint where it inhibits binding of pain receptors and thus blocking the pain transmission signals into the brain.

•Collagen fiber development

Injections with hyaluronic acid are associated with increased collagen development, a soft tissue protein involved in movement allowing for repair with reduced pain.

•Shock absorbing properties

Due to its viscous nature, injected hyaluronic acid acts as a shock absorber, in turn, reducing pain.

Risks associated with the use of hyaluronic acid injections for hemiplegic shoulder pain include;

•Pain, swelling and stiffness in the site of injection.
•Nausea
•Headache and dizziness
•Back pain
•Some are associated with allergic reactions including rashes and hives although it is a rare complication.

Hyaluronic acid injections should not be given to patients who;

•Have circulatory problems.
•Allergic to hyaluronic acid.
•Pregnant and breastfeeding mothers.
•Use blood thinning medications.