Pain after a stroke

Pain after stroke - the situation is quite common. About 10% of stroke suffer from pain of various parts of the body. The intensity of pain after a stroke is, ranging from a moderate, bringing some discomfort, ending with such a powerful pain that it can even interfere with the recovery of the body.

[1], [2], [3]

Symptoms of pain after a stroke

Central post-stroke pain

Based on the location of the pain that occurs after a stroke, the symptoms vary. If the pain after the stroke is observed on one side of the body, most often on the limbs (pain in the hand after a stroke, leg pain after a stroke) is one of the typical symptoms that a stroke of the brain such as the thalamus was affected in a stroke. Such pain after a stroke is central. Patients endow it with different characteristics: burning, drilling pain, shooting. In terms of intensity, thalamic pain can also vary, often the "stroke" has to take medication to calm the pain.

However, central post-stroke pain occurs not only when the thalamus is affected: as practice shows, it also appears in situations where vnetalamicheskie structures are affected. Many scientists agree that this type of pain is caused by post-stroke disorders of almost any part of the human brain. Most often this happens when the visual hillock and caudal divisions of the brain, as well as the parietal areas of the cortex, "suffer". And not every time the visual mound is damaged, pain syndrome is observed.

Pain after a stroke can be aggravated by various factors: movements, heat or cold, emotions. However, in some stroke patients, the same moments can reverse the pain after a stroke, especially with regard to heat. There are other neurological symptoms, which cause central post-stroke pain: with hyperesthesia, dysesthesia, numbness, changes in sensation of heat, cold, touch, vibrations. A special perception of temperature, tactile sensations, vibrations is a characteristic "bell" in the diagnosis of central neuropathic pain after a stroke. Researches give such results: more than 70% of patients complaining of central post-stroke pain do not feel the difference at a temperature run-off of 0-50 ° C. Also, with neuropathic pain, allodynia is observed - an unnatural soreness of the skin. It is observed in 71% of stroke patients.

[4], [5], [6], [7]

Pain in the shoulder after a stroke

Pain after a stroke can occur when any of the muscle groups are immobilized. Such pain occurs as a result of peripheral lesions.

A typical situation is pain in the shoulder after a stroke. It can appear when the brachial plexus is damaged, muscles of the shoulder girdle are tense, a subluxation is observed in the shoulder joint. As for the latter, it occurs at early post-stroke terms before the very pain in the muscles after a stroke. Its cause is weakened muscles, their low tone, because of which the joint capsule gradually overstrains under the weight of the hand and subsequently leads to an incorrect position of the head of the humerus.

Pain in muscles after a stroke

Muscle pain after a stroke - muscle spasms - occurs in stroke at the first time (a month or two) after a stroke and the associated cerebral circulatory disorders. These pains are due to the progressive spasticity of the muscles.

Classification of pain after a stroke

Pain after a stroke happens:

• central post-stroke pain;
• Affected joints of paretic limbs;
• pain after a stroke, caused by painful spasms of the muscles of the paretic limbs.

[8], [9]

Treatment of pain after a stroke

First, it is important to determine in which part of the body the pain after the stroke is concentrated, to understand where and when it occurs. Check the moment of its appearance: whether it causes any of your actions or movements, after which it appears. The best way out in the situation of pain after a stroke will be to consult a doctor to find the appropriate methods for its elimination, medications, physical therapy, etc. After all, everything is always individual and depends on the specific organism, and only the doctor can determine the reasons most accurately. There are patients who are embarrassed to talk about their pain after a stroke to the doctor, because they believe that this is a weakness. This is fundamentally wrong, because such a position can provoke a slowdown in the recovery of the body after a stroke, and sometimes even worsen the condition. Therefore, experts strongly recommend to monitor their feelings, even write down in the diary, where and how often there is pain after a stroke.

With central post-stroke pain, when a specific area of the brain is affected, controlling the subjective sensations, the usual analgesics do not give effect, since they act in a different way. When one half of the body hurts, for example, there is pain in the hand after a stroke or pain in the foot after a stroke, two groups of drugs are often used:

• antidepressants: amitriptyline, analgesic effect has also simbalta;
• anticonvulsants: finlepsin (carbamazepine), gabapentin, lyric.

These drugs are used, both simultaneously and separately. A significant effect is observed after 4-8 weeks of treatment.

When there is muscle pain after a stroke, treatment is usually done in the direction of eliminating spasticity of the muscles. For this, muscle relaxants (sirdalud, baclosan, midocalm), position treatment, physiotherapy (heat therapy or cryotherapy), massage and special therapeutic gymnastics are used.

However, in case of any pain after a stroke, it is most rational to contact a doctor who will choose the most effective drug in each case.

Physiotherapy for pain after a stroke

To treat the pain after a stroke, a wide variety of physiotherapeutic treatments are used everywhere: electrotherapy (CMT, DDT, electrophoresis of drugs, electrotherapy of paretic muscles), laser therapy, magnetotherapy, heat treatment (paraffin and ozokeritotherapy), massage, exercise therapy, acupuncture.

Alternative methods of treatment of pain after a stroke

Rubbing with oils makes it possible to restore the sensitivity of the limbs. Also give the effect of a bath of pine needles, decoction of rose hips (roots), celandine.

To rub the parts of the body that are paralyzed by a stroke, you can prepare a special ointment. Recipe - alcohol and vegetable oil in a 1: 2 ratio.

[10], [11], [12], [13], [14]

Prevention of pain after a stroke

Pain after a stroke can be caused by various factors. To prevent its occurrence, doctors advise to adhere to such recommendations:

• avoid hot tubs;
• do not allow the body to be densely grouped;
• do not wear too light clothes;
• do not allow pressure on the side that was hit;
• be in a comfortable position of the body;
• Use devices for the limbs that are weakened or paralyzed;
• when sitting or lying down, fix a paralyzed hand on a special stand (pillow, armrest) so that the pain in the shoulder after a stroke is not aggravated by the weight of the arm.
• on the move it is desirable to support another person.

Pain after a stroke can and should be treated. Post-stroke pain syndromes are diverse in their mechanisms of manifestation and methods of treatment. Timely appeal to the doctor is the key to an early recovery.