Prevalence and intensity of pain after stroke: a population based study focusing on patients' perspectives
2005/12/15 by A-C Jonsson, A.-C. Jönsson · 286 citations
Medicine · #Acute Ischemic Stroke Management #Cognition #Depression (economics) #Depressive symptoms #Geriatric Depression Scale #Intensity (physics) #Internal medicine #Medicine #Pain Management and Opioid Use #Physical therapy #Population #Psychiatry #Stroke (engine) #Stroke Rehabilitation and Recovery #Visual analogue scale
paper · pdf · doi:10.1136/jnnp.2005.079145
published in Journal of Neurology Neurosurgery & Psychiatry 77(5), 590-595 (BMJ)
openalex publication_date 2005/12/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
Abstract
OBJECTIVE: To determine prevalence and intensity of pain after stroke, focusing on patients' perspectives. METHODS: During a one year period, 416 first-ever stroke patients were included in the population based Lund Stroke Register. After 4 and 16 months (median), 297 patients (98% of survivors) were followed up. Worst pain intensity during the previous 48 hours was assessed on a visual analogue scale (VAS), range 0 to 100: a score of 0 to 30 was defined as no or mild pain; 40 to 100 as moderate to severe pain. NIH stroke scale (NIHSS) score and HbA1c were assessed at baseline. At 16 months, screening for depression was done using the geriatric depression scale (GDS-20), and cognition with the mini-mental state examination (MMSE). Predictors of pain were determined by multivariate analyses. RESULTS: Moderate to severe pain was reported by 96 patients (32%) after four months (VAS median=60). Predictors of pain were younger age (p=0.01), female sex (p=0.006), higher NIHSS score (p<0.001), and raised HbA1c (p=0.001) at stroke onset. At 16 months, only 62 patients (21%) had moderate to severe pain, but pain intensity was more severe (median VAS score=70; p<0.016). Higher pain intensity correlated with female sex, worse GDS-20 score, better MMSE score, and raised HbA1c. Pain was persistent in 47%, disturbed sleep in 58%, and required rest for relief in 40% of patients. CONCLUSIONS: Although prevalence of pain after stroke decreased with time, after 16 months 21% had moderate to severe pain. Late pain after stroke was on average more severe, and profoundly affected the patients' wellbeing.
Citations
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