Pain is one of the several unexpected consequences ofstroke. Post-stroke pain is not typically among the early stroke symptoms, and it may take weeks or months for post-stroke pain to develop.Because it takes a while for post-stroke pain to begin, stroke survivors often consider the physical pain after a stroke to be related to “aging,” stress, or something else.
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Approaches to Different Types of Post-Stroke Pain
There are several different kinds of post-stroke pain, and each requires a tailored approach. So, if you personally have post-stroke pain and if you also know someone else who also has post-stroke pain, you might not be getting the same treatment if your pain is not in the same category.
Spasticity-Induced Pain
Central Pain
A type of pain called central pain affects about 10% of stroke survivors. Central pain is not well understood, and it is believed to be the result of a complex response of the brain to the stroke injury, resulting in hypersensitivity.
Most stroke survivors who have central pain complain of severe and persistent pain that may include aching, burning, tingling, tenderness or other unpleasant sensations. Generally, central pain is associated with strokes that cause moderate loss of muscle strength and mild to moderate decreased sensation, and not typically with strokes that cause a complete loss of strength or a complete loss of sensation.
Standard pain medications are not usually successful in controlling central pain. Anti-seizure medications and antidepressants have been found to be the most effective methods for reducing central pain.
The American Heart Association (AHA) treatment guidelines for post-stroke central pain recommend an individualized approach to determining the best treatment approach for patients, including a thorough consideration of response to treatment and any side effects.
Musculoskeletal Pain
Musculoskeletal pain is often described as a pain or aching of the muscles, often in the shoulders, neck, arms, legs, or back. Musculoskeletal pain is the most common type of post-stroke pain. It is unlike the discomfort of muscle spasticity and distinct from central pain, although some stroke survivors experience more than one type of post-stroke pain.
Musculoskeletal pain is usually mild to moderate in severity and typically improves with standard pain medications. However, sometimes, musculoskeletal pain can be so intense that it prevents you from exerting your full effort when you move your muscles, because routine movements may aggravate the pain.
Post-stroke musculoskeletal pain can be one of the more substantial setbacks when it comes tostroke recovery and rehabilitation. Therefore, it is important to discuss your pain with your medical team, so that you can continue to recover at your most optimal level once you achieve pain control.
Headaches
As many as 20% to 30% of stroke survivors begin to experienceheadachesfor the first time after having a stroke. Some stroke survivors who already had headaches prior to the stroke may experience worsened headaches after a stroke. All strokes can trigger new headaches during the recovery period, but hemorrhagic strokes are the most highly associated with headaches during, and even after, stroke recovery.
Phantom Limb Pain
Phantom limb painis a relatively uncommon, yet agonizing type of pain. Phantom limb pain is most often described as pain coming from the location of an arm or a leg that has been amputated and, thus, does not even exist.
Yet, stroke survivors who have profound weakness or complete sensory loss can also feel as if their arm or leg is “not there,” and may experience phantom limb pain. There are medications and rehabilitative therapeutic techniques for phantom limb pain. The treatment needs to be specifically tailored to the individual stroke survivor, because not everyone who suffers from phantom limb pain improves with the same treatment approach.
A Word From Verywell
Pain is an unwelcome and surprising stroke effect that usually begins well after the initial stroke phase stabilizes. The majority of stroke survivors experience some type of pain for a period of time, but the pain usually improves with medical treatment and, after a while, the physical discomfort might improve sufficiently enough that medical treatment is no longer needed.
Pain is a difficult problem to live with, and some people may be tempted to just “tough it out.” However, there are effective treatment options for post-stroke pain, so you should know that you can experience your stroke recovery without the additional hardship of pain.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Treister AK, Hatch MN, Cramer SC, Chang EY.Demystifying poststroke pain: From etiology to treatment.PM R. 2017;9(1):63–75. doi:10.1016/j.pmrj.2016.05.015Francisco GE, McGuire JR.Poststroke spasticity management.Stroke. 2012;43(11):3132-6. doi:10.1161/STROKEAHA.111.639831Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Winstein CJ, Stein J, et al.American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.Antoniello D, Kluger BM, Sahlein DH, Heilman KM.Phantom limb after stroke: An underreported phenomenon.Cortex. 2010;46(9):1114-22. doi:10.1016/j.cortex.2009.10.003
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Treister AK, Hatch MN, Cramer SC, Chang EY.Demystifying poststroke pain: From etiology to treatment.PM R. 2017;9(1):63–75. doi:10.1016/j.pmrj.2016.05.015Francisco GE, McGuire JR.Poststroke spasticity management.Stroke. 2012;43(11):3132-6. doi:10.1161/STROKEAHA.111.639831Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Winstein CJ, Stein J, et al.American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.Antoniello D, Kluger BM, Sahlein DH, Heilman KM.Phantom limb after stroke: An underreported phenomenon.Cortex. 2010;46(9):1114-22. doi:10.1016/j.cortex.2009.10.003
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Treister AK, Hatch MN, Cramer SC, Chang EY.Demystifying poststroke pain: From etiology to treatment.PM R. 2017;9(1):63–75. doi:10.1016/j.pmrj.2016.05.015Francisco GE, McGuire JR.Poststroke spasticity management.Stroke. 2012;43(11):3132-6. doi:10.1161/STROKEAHA.111.639831Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Winstein CJ, Stein J, et al.American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.Antoniello D, Kluger BM, Sahlein DH, Heilman KM.Phantom limb after stroke: An underreported phenomenon.Cortex. 2010;46(9):1114-22. doi:10.1016/j.cortex.2009.10.003
Treister AK, Hatch MN, Cramer SC, Chang EY.Demystifying poststroke pain: From etiology to treatment.PM R. 2017;9(1):63–75. doi:10.1016/j.pmrj.2016.05.015
Francisco GE, McGuire JR.Poststroke spasticity management.Stroke. 2012;43(11):3132-6. doi:10.1161/STROKEAHA.111.639831
Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019
Winstein CJ, Stein J, et al.American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.
Antoniello D, Kluger BM, Sahlein DH, Heilman KM.Phantom limb after stroke: An underreported phenomenon.Cortex. 2010;46(9):1114-22. doi:10.1016/j.cortex.2009.10.003
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