BSPRM consensus paper published on shoulder pain in adults with neurological conditions
The British Society of Physical and Rehabilitation Medicine (BSPRM) is delighted to announce the publication of a landmark new consensus paper:
Shoulder pain in adults with a neurological condition: Prevention, assessment and management of shoulder pain following acquired brain injury, spinal cord injury and other neurological diagnoses
Officially launched at the BSPRM Annual Conference 2026 in Edinburgh, the paper provides an important new reference for healthcare professionals involved in the assessment, prevention and management of shoulder pain in adults with neurological conditions.
Shoulder pain is a common and potentially disabling complication of neurological conditions. It can negatively impact participation in rehabilitation, independence and quality of life. This consensus document addresses the significant need for clear, practical guidance tailored to this complex patient population.
Developed by an expert multidisciplinary working party, the paper brings together the best available evidence and clinical consensus. It applies to adults at risk of developing, or already experiencing, shoulder pain associated with conditions including stroke, traumatic brain injury, multiple sclerosis, Guillain–Barré syndrome and spinal cord injury.
The document provides practical recommendations covering:
- clinical presentation and diagnosis
- comprehensive assessment and appropriate investigations
- prevention, including positioning, safe handling and education
- strengthening and functional task practice
- neuromuscular electrical stimulation
- physical and targeted focal treatments
- management of spasticity-related shoulder pain
- analgesia and the biopsychosocial management of pain
- multidisciplinary and person-centred care
Its national and international significance is reflected in endorsement from the International Society of Physical and Rehabilitation Medicine (ISPRM), the European Society of Physical and Rehabilitation Medicine (ESPRM), the British and Irish Association of Stroke Physicians (BIASP), the British Pain Society (BPS) and other leading organisations.
“This consensus paper offers a comprehensive understanding of the various physiological mechanisms underlying shoulder pain in this population and presents three key principles of management: prevention, treatment of the underlying condition causing the pain, and analgesic management. We hope that it will provide a foundation for improving understanding and clinical practice in this field, while highlighting areas of uncertainty and encouraging high-quality research to inform future developments.” – Dr. Celine Lakra, Working Party Chair
BSPRM extends its sincere thanks to Dr Celine Lakra, Rachel Higgins and every member and consultee of the multidisciplinary working party whose expertise and commitment made this publication possible. The consensus process was completed without third-party sponsorship.
We hope this important publication will become a key reference for rehabilitation physicians, physiotherapists, occupational therapists, nurses and the wider multidisciplinary teams.
“Shoulder pain is a common problem for people undergoing rehabilitation after an acute neurological problem as well as those living with long term neurological conditions. I am glad that BSPRM has come out with this consensus paper. This paper fills a significant gap in literature. The paper has been developed by an intense iterative process involving professionals from different disciplines. I am grateful to Dr Celine Lakra and team for their effort. It will be a useful reference for professionals involved in neurological and musculoskeletal rehabilitation” – Professor K P Sivaraman Nair, BSPRM President.