Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2020

Open Access 01-12-2020 | Stroke | Research article

Experienced pain after stroke: a cross-sectional 5-year follow-up study

Authors: Emma Westerlind, Ramanjit Singh, Hanna C. Persson, Katharina S. Sunnerhagen

Published in: BMC Neurology | Issue 1/2020

Login to get access

Abstract

Background

Stroke is one of the most common cause of disability worldwide. Pain is common in both stroke survivors and in the general population. Consequences of post-stroke pain (PSP) include reduced quality of life and are important to consider. The aim of the current study was to explore the experience of pain 5 years after stroke, and factors associated with the experience of pain.

Methods

Inclusion criteria were: First ever stroke, treated at Sahlgrenska University Hospital, Sweden, during an 18 months period in 2009–2010, aged 18 years or older. Furthermore, the participants had to respond to a set of questionnaires 5 years post-stroke. Baseline data were collected from medical records and follow-up data from the set of questionnaires. The primary outcome was based on the question Do you experience pain? Predictors and explanatory factors for experiencing more frequent pain were analysed with logistic regression.

Results

A total of 281 participants were included. Almost 40% experienced pain to some degree 5 years post-stroke (15% reported pain frequently), and 25% felt that their needs for pain treatment were not met. The participants experiencing more frequent pain reported poorer quality of life, self-perceived health status and recovery post-stroke. Functional dependency at discharge from hospital, experiencing depression at follow up and restricted mobility at follow up were all associated with more frequent pain.

Conclusion

Pain is common 5 years post-stroke and the treatment is not perceived as optimal. The persons experiencing more frequent pain seem to rate their health and recovery worse than the persons experiencing less frequent pain. Most of the factors associated with more frequent pain were treatable and this emphasize the importance of standardised follow-up care that takes pain into consideration.
Literature
1.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2095–128.PubMedCrossRef
2.
Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, Barker-Collo S, Moran AE, Sacco RL, Truelsen T, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study. Neuroepidemiology. 2015;45(3):161–76.PubMedCrossRef
3.
Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, van Dijk EJ, de Leeuw FE. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol. 2014;10(6):315–25.PubMedCrossRef
4.
5.
Skevington SM. Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL. Pain. 1998;76(3):395–406.PubMedCrossRef
6.
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333.PubMedCrossRef
7.
Azevedo LF, Costa-Pereira A, Mendonca L, Dias CC, Castro-Lopes JM. Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain. 2012;13(8):773–83.PubMedCrossRef
8.
Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization study in primary care. JAMA. 1998;280(2):147–51.PubMedCrossRef
9.
Harrison RA, Field TS. Post stroke pain: identification, assessment, and therapy. Cerebrovasc Dis. 2015;39(3–4):190–201.PubMedCrossRef
10.
Jonsson AC, Lindgren I, Hallstrom B, Norrving B, Lindgren A. Prevalence and intensity of pain after stroke: a population based study focusing on patients' perspectives. J Neurol Neurosurg Psychiatry. 2006;77(5):590–5.PubMedCrossRef
11.
Hansen AP, Marcussen NS, Klit H, Andersen G, Finnerup NB, Jensen TS. Pain following stroke: a prospective study. Eur J Pain. 2012;16(8):1128–36.PubMedCrossRef
12.
Klit H, Finnerup NB, Jensen TS. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009;8(9):857–68.PubMedCrossRef
13.
14.
Delpont B, Blanc C, Osseby GV, Hervieu-Begue M, Giroud M, Bejot Y. Pain after stroke: a review. Rev Neurol (Paris). 2018;174(10):671–4.CrossRef
15.
Lundstrom E, Smits A, Terent A, Borg J. Risk factors for stroke-related pain 1 year after first-ever stroke. Eur J Neurol. 2009;16(2):188–93.PubMedCrossRef
16.
Widar M, Samuelsson L, Karlsson-Tivenius S, Ahlstrom G. Long-term pain conditions after a stroke. J Rehabil Med. 2002;34(4):165–70.PubMedCrossRef
17.
Widar M, Ek AC, Ahlstrom G. Coping with long-term pain after a stroke. J Pain Symptom Manag. 2004;27(3):215–25.CrossRef
18.
Chae J, Yu D, Walker M. Percutaneous, intramuscular neuromuscular electrical stimulation for the treatment of shoulder subluxation and pain in chronic hemiplegia: a case report. Am J Phys Med Rehabil. 2001;80(4):296–301.PubMedCrossRef
19.
Persson HC, Parziali M, Danielsson A, Sunnerhagen KS. Outcome and upper extremity function within 72 hours after first occasion of stroke in an unselected population at a stroke unit. Part SALGOT Study BMC Neurol. 2012;12:162.PubMedCrossRef
20.
Vikholmen K, Persson HC, Sunnerhagen KS. Stroke treated at a neurosurgical ward: a cohort study. Acta Neurol Scand. 2015;132(5):329–36.PubMedCrossRef
21.
Wesali S, Persson HC, Cederin B, Sunnerhagen KS. Improved survival after non-traumatic subarachnoid haemorrhage with structured care pathways and modern intensive care. Clin Neurol Neurosurg. 2015;138:52–8.PubMedCrossRef
22.
Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, Spilker J, Holleran R, Eberle R, Hertzberg V, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864–70.PubMedCrossRef
23.
Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28(1):14–20.PubMedCrossRef
24.
van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19(5):604–7.PubMedCrossRef
25.
Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke. 1999;30(8):1538–41.PubMedCrossRef
26.
Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol group. Ann Med. 2001;33(5):337–43.PubMedCrossRef
27.
Duncan PW, Bode RK, Min Lai S, Perera S. Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale. Arch Phys Med Rehabil. 2003;84(7):950–63.PubMedCrossRef
28.
Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999;30(10):2131–40.PubMedCrossRef
29.
Field A: Discovering statistics using IBM SPSS statistics : and sex and drugs and rock 'n' roll, 4. edn. Los Angeles London: Sage; 2013.
30.
Dragioti E, Larsson B, Bernfort L, Levin LA, Gerdle B. Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+). J Pain Res. 2016;9:1131–41.PubMedPubMedCentralCrossRef
31.
Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016;6(6):e010364.PubMedPubMedCentralCrossRef
32.
Appelros P. Prevalence and predictors of pain and fatigue after stroke: a population-based study. Int J Rehabil Res. 2006;29(4):329–33.PubMedCrossRef
33.
Hansen AP, Marcussen NS, Klit H, Kasch H, Jensen TS, Finnerup NB. Development of persistent headache following stroke: a 3-year follow-up. Cephalalgia. 2015;35(5):399–409.PubMedCrossRef
34.
McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106(1–2):127–33.PubMedCrossRef
35.
Magni G, Moreschi C, Rigatti-Luchini S, Merskey H. Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain. Pain. 1994;56(3):289–97.PubMedCrossRef
36.
Towfighi A, Ovbiagele B, El Husseini N, Hackett ML, Jorge RE, Kissela BM, Mitchell PH, Skolarus LE, Whooley MA, Williams LS. Poststroke depression: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2017;48(2):e30–43.PubMedCrossRef
37.
Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke. 2014;9(8):1017–25.PubMedCrossRef
38.
Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8(8):741–54.PubMedCrossRef
39.
Tse MM, Tang SK, Wan VT, Vong SK. The effectiveness of physical exercise training in pain, mobility, and psychological well-being of older persons living in nursing homes. Pain Manag Nurs. 2014;15(4):778–88.PubMedCrossRef
40.
41.
Bergman S, Herrstrom P, Hogstrom K, Petersson IF, Svensson B, Jacobsson LT. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol. 2001;28(6):1369–77.PubMed
42.
Philp I, Brainin M, Walker MF, Ward AB, Gillard P, Shields AL, Norrving B. Global stroke community advisory P: development of a poststroke checklist to standardize follow-up care for stroke survivors. J Stroke Cerebrovasc Dis. 2013;22(7):e173–80.PubMedCrossRef
43.
Eriksen J, Jensen MK, Sjogren P, Ekholm O, Rasmussen NK. Epidemiology of chronic non-malignant pain in Denmark. Pain. 2003;106(3):221–8.PubMedCrossRef
Metadata
Title
Experienced pain after stroke: a cross-sectional 5-year follow-up study
Authors
Emma Westerlind
Ramanjit Singh
Hanna C. Persson
Katharina S. Sunnerhagen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-019-1584-z

Other articles of this Issue 1/2020

BMC Neurology 1/2020 Go to the issue

Case report

A case report of severe tuberous sclerosis complex detected in utero and linked to a novel duplication in the TSC2 gene

Study protocol

Improving symptom burden in adults with persistent post-concussive symptoms: a randomized aerobic exercise trial protocol

Research article

Randomized, placebo-controlled, double-blind, pilot trial to investigate safety and efficacy of Cerebrolysin in patients with aneurysmal subarachnoid hemorrhage

Research article

Discussing personalized prognosis in amyotrophic lateral sclerosis: development of a communication guide

Research article

Comparing healthcare cost associated with the use of enzyme-inducing and non-enzyme active antiepileptic drugs in elderly patients with epilepsy in the UK: a long-term retrospective, matched cohort study

Research article

HIV infection, seasonality and younger age predicting incident Bell’s palsy among black South Africans