Pain Management

Many stroke survivors experience pain. Pain can happen if there is real or potential damage to body tissue. It can also be felt if the nerves have been damaged.

It’s common to experience shoulder pain and other musculoskeletal problems after stroke. Pain will usually be on the side of the body affected by the stroke. Pain is often caused by high tone, which is also called hypertonia or spasticity. High tone makes the muscles very tight or stiff. Contracture, where the muscles or joints become shorter or less flexible, can also cause pain. Subluxation is caused by weakness or low tone that allows the top of your arm to drop out of the shoulder socket slightly. This can be very painful.

Neuropathic pain is caused by damaged nerves that send incorrect or extra messages. Neuropathic pain may start days, months or years after your stroke. Central post stroke pain (CPSP) is a type of neuropathic pain that may feel like burning, stabbing, prickling or numbness on the skin on the side affected by your stroke.

Headaches are more common after haemorrhagic stroke. It is not always known what causes headaches but it can sometimes be a side effect of medications.

Pain makes daily life difficult, and can wear you down over time. Pain experts emphasise that even if you can’t make your pain go away, it is almost always possible to reduce pain levels and to improve quality of life.

Treatment includes medication as well as other strategies. These include psychological techniques like cognitive behavioural therapy, hypnosis, attention-diversion strategies and biofeedback. Stress management and relaxation techniques can also help. Treatment may also include transcutaneous electrical nerve stimulation (TENS), exercise, positioning and supportive devices. Keeping active, eating a healthy diet and limiting tobacco, alcohol and caffeine can also help.

It helps to talk to trusted family members and friends about your pain. Take opportunities to talk about how you’re feeling, and ask for their help and support.

Pain that lasts for more than three months is known as chronic pain.  A pain management clinic can provide special programs to help you with chronic pain. Your doctor can arrange access to a pain clinic if appropriate for you.