Spasticity and pain, particularly int he shoulder region, are the most common impairments experienced by subjects who had experienced a stroke. There is preliminary evidence supporting the role of dry needling for spasticity in patients who had suffered from a stroke. Few data exists on the effects on shoulder pain. In addition, it has been shown that application of dry needling induces post-needling soreness in individuals with musculoskeletal pain. No previous study has investigated the presence and the duration of post-needling soreness in individuals who had experienced a stroke.

Inclusion Criteria:

• first-ever unilateral stroke;
• hemiplegia resulting from stroke;
• age between 30 and 60 years old;
• presence of hypertonicity in the upper extremity;
• pain symptoms in the shoulder
• active trigger points in the shoulder muscles reproducing the shoulder pain symptoms

Exclusion Criteria:

• recurrent stroke;
• absence of active trigger points in the shoulder muscles reproducing shoulder symptoms
• previous treatment with nerve blocks, motor point injections with neurolytic agents for spasticity at any time;
• previous treatment with botulinum toxin-A in the 6 months prior the study;
• severe cognitive deficits;
• other neurologic diseases,
• underlying complex medical conditions, e.g., heart conditions, unstable hypertension, fracture
• fear to needles;
• any contraindication for deep dry needling, e.g., anticoagulants, infections, bleeding, or psychotic.