Case of the month #11: Post Stroke Pain

Published: 04/01/2022


Stroke is one of the leading causes of adult death and disability – there are around 13.7 million patients who have a stroke per year. Up to 40% of these patients will end up with chronic pain which can be of multiple aetiology (stroke pain syndromes) as discussed below. The impact on quality of life and health resources is therefore immense. Musculoskeletal pain occurs in as much as 70% of patients starting in the acute phase due to immobility and persisting or becoming worse as more joints and muscle groups are affected. In the immediate period following the stroke, headaches are very common.  

Central post stroke pain occurs in up to 20% of patients and may take some time to develop. It is typical of neuropathic pain and is perceived as tingling, parasthasiae, allodynia and hyperalgesia. 

Depression, anxiety and sleep disorders making rehabilitation more difficult. Expressive dysphasia can make history taking and diagnosis more challenging. 

Pain after stroke is often not recognised by clinicians with only a small percentage of sufferers being referred to pain services.