Strokes Raise Risk of Chronic Pain

Strokes Raise Risk of Chronic Pain

bigstock-Human-brain-chart-with-colored-11863427(2)Patients who suffer a stroke from a blood clot have a higher risk of developing chronic pain, according to a new study published in the American Heart Association journal Stroke.

In the largest study of its kind — involving more than 15,000 stroke survivors — researchers found that over 10 percent developed chronic pain.

“Chronic pain syndromes are common, even following strokes of mild to moderate severity,” said Martin J. O’Donnell, MD, lead author and professor of translational medicine at the National University of Ireland in Galway.

“It is associated with greater decline in physical and cognitive function, making it an important medical complication after stroke.”

For over two years researchers followed people who had survived mild to moderate strokes. The patients, who did not have a history of chronic pain before their initial stroke, were enrolled in a trial of treatments aimed at preventing a second stroke.

The most common types of chronic pain reported after an ischemic stroke were neuropathic pain, tight or stiff muscles (spasticity), unexplained shoulder pain and central stroke pain. The latter involves a change in the brain that can cause a simple touch or sensation to be perceived as pain.

Stroke patients who developed chronic pain were more than twice as likely to become more dependent on caregivers

“We suspect that some of the association between chronic pain and decline in cognitive test performance may be related to the use of medications to treat pain, but this was not evaluated in our study” said O’Donnell. “Our study emphasizes the importance of evaluating interventions to prevent post-stroke pain in high-risk individuals.”

Patients at higher risk of developing chronic pain after strokes are women, people who drink more alcohol and patients with a history of diabetes, depression or vascular disease.

“Our findings show that new chronic pain syndromes are an important long-term complication of ischemic stroke, even in a patient population with mild-to-moderate-severity ischemic stroke,” the authors wrote. “Clinical trials, designed to prevent post-stroke pain syndromes, would seem to be an obvious target of future clinical research.”

Authored by: Richard Lenti

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Mark S. Barletta

Stroke is a medical emergency. Treatment is available, but only if the stroke is recognized in time. The most common sign of stroke is sudden weakness of the face, arm or leg, more often on one side of the body.

Other warning signs may include:
•Sudden numbness of the face, arm or leg, especially on one side of the body.
•Confusion, trouble speaking or understanding speech
•Sudden difficulty seeing in one or both eyes
•Trouble Walking, dizziness, loss of balance or coordination
•Sudden severe headache with no known cause

Drug treatment has been shown to limit the disability from strokes caused by clots (ischemic strokes), but it must be given within three hours of the onset of stroke symptoms. Because of this short time window, it is important that the onset of a stroke be identified quickly.

According to a report presented at the American Stroke Associations 28th International Stroke Conference, a bystander may be able to identify someone having a stroke by asking that person to complete three simple acts:
•to smile
•to raise both arms and keep them up
•to speak a simple sentence coherently

The test, which takes less than one minute, has enabled healthcare professionals to accurately identify stroke patients. If a bystander can relay the results of this test to an emergency dispatcher, it could speed up treatment to the stroke patient. If a friend or family member’s speech unexpectedly becomes slurred or incomprehensible, immediately call 911 or your local emergency number. The same is true if one side of someone’s body becomes numb, he or she cannot hold up both arms, or if one side of the face droops down.

Even if the symptoms pass quickly, they could be an important warning that requires prompt medical attention.