Inclusion Criteria:  1. Patient's age ranges from 40 to 60 years. 2. Spasticity of upper limb ranges from mild to moderate (grade 1+: 2) according to modified aschworth scale (MAS).  3. Patients with sufficient cognitive abilities that enables them to understand and follow instructions (Mini-Mental Scale >24).  4. Patient who understand the study process and signed the informed consent form.  5. Patient with stroke more than 3 months ago. 8. Patient with shoulder pain and limited range of motion (ROM) or loss of motion in the proximal arm on the hemiplegic side.  Exclusion Criteria:  The following patients will be excluded from the study:  Patients who cannot express their own pain intensity. Patients with a history of trauma or surgery to the shoulder on the affected side. Patients with history of oral NSAIDs 3 days before this study or take warfarin medication with an international normalized ratio above 4.0. Patients with a history of shoulder pain before the stroke.  6. Patients who have received a previous shoulder intra-articular injection or other interventions on the affected shoulder within one month before rESWT.  7. Patients with cardiac pacemaker. 8. Patients who have osteoporosis. 9. Patients with psychological problems.