Combined Prolotherapy and Physical Therapy in a 60-Year-Old Man with Left Shoulder Pain and Limited Range of Motion (Frozen Shoulder) Following a Hemiplegic Stroke: A Case Report

Abstract

Patient: Male, 60-year-old Final Diagnosis: Hemiparetic frozen shouler Symptoms: Shoulder pain with limited range of motion Clinical Procedure: Prolotherapy injection combined with physical therapy intervention Specialty: Rehabilitation Objective: Unknown etiology Background: Frozen shoulder with limited range of motion is a common and debilitating condition that occurs on the affected side following a stroke. The effectiveness of therapy was reported to be negatively correlated with the complexity of pathogenesis. Prolotherapy involves injection into the joint of a small amount of irritant, such as dextrose, which enhances tissue strength and facilitates healing by targeting joint spaces. The treatment is used to relieve pain. This report describes the effects of combined prolotherapy and physical therapy in a 60-year-old man with left shoulder pain and limited range of motion (frozen shoulder) following a hemiplegic stroke. Case Report: A 60-year-old man had left shoulder pain and limited ROM for 9 months, which disrupted daily life, with a NRS of 7 and a DASH score of 58.3%. The patient had an ischemic stroke 1 year ago, with left extremity weakness. On physical examination, joint active ROM was significantly restricted and the joint was tender upon palpation. Therapy is carried out using prolotherapy combined with exercise and physical therapy for 6 weeks. At the 6-week follow-up, he had good outcomes for pain relief, increasing ROM, and quality of life. Conclusions: The use of prolotherapy with physical therapy may be an effective treatment for painful frozen shoulder following a hemiplegic stroke.