Persistent Pain Common After Stroke

A new study reports that patient-reported pain is common shortly after stroke, and the pain may persist for months.

Researchers from Lund University Hospital (Sweden) examined a total of 297 first-time stroke patients who were registered in the Lund stroke register and selected for their ability to complete the visual analog scale (VAS). The researchers examined the prevalence, intensity, and predictors of pain following stroke from the patients' perspectives. VAS scores of 0-30 were defined as no pain or mild pain while scores of 40-100 were considered to be moderate-to-severe pain.

After four months, 96 patients (32%) reported moderate-to-severe pain, 23 had mild pain, and 178 had no pain. Significant predictors of pain included younger age, female sex, higher U.S. National Institutes of Health (NIH) stroke scale score, and higher HbA1c values. At 16 months, 62 patients (21%) had moderate-to-severe pain, 12 patients had mild pain, and 223 had no pain. Pain intensity was more severe at 16 months than at four months, with median VAS scores of 70 and 60, respectively. A correlation was noted between higher pain intensity and female sex, worse geriatric depression scores, better mini-mental state examination score, and higher HbA1c baseline values.

Pain was constant in up to 47% of subjects reporting pain at both follow-up assessments, and was often present in up to 68%, reported Dr. Ann-Cathrin Jonsson and colleagues. Disturbed sleep attributed to pain occurred in at least 49-58% patients with moderate-to-severe pain. At both follow-up periods, up to 50% of patients required temporary rest for pain relief and about 25% obtained pain relief only by changing position. The results were published in the May 2006 issue of the Journal of Neurology, Neurosurgery, and Psychiatry.



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