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Comparative Study
. 2011;6(11):e27607.
doi: 10.1371/journal.pone.0027607. Epub 2011 Nov 15.

Pain Following Stroke: A Population-Based Follow-Up Study

Free PMC article
Comparative Study

Pain Following Stroke: A Population-Based Follow-Up Study

Henriette Klit et al. PLoS One. .
Free PMC article


Background and purpose: Chronic pain is increasingly recognized as a consequence of stroke. This study aimed to describe the prevalence and pain types of new onset chronic pain ("novel pain") in patients with stroke compared with a randomly selected reference group from the general population and to identify factors associated with pain development in stroke patients.

Methods: In a population-based follow-up design, development of chronic pain after stroke was assessed by a questionnaire sent to consecutive stroke patients, registered in a Danish national stroke database, two years after their stroke. A randomly selected sex- and age-matched reference group from the same catchment area received a similar questionnaire about development of new types of chronic pain in the same time period. A total of 608 stroke patients and 519 reference subjects were included in the study.

Results: Development of novel pain was reported by 39.0% of stroke patients and 28.9% of reference subjects (OR 1.57, CI 1.21-2.04), and was associated with low age and depression in a multivariate model. Daily intake of pain medication for novel pain was reported by 15.3% and 9.4% of the stroke and reference population, respectively. Novel headache, shoulder pain, pain from increased muscle stiffness, and other types of novel pain were more common in stroke patients, whereas joint pain was equally common in the two groups.

Conclusions: Development of chronic pain is more common in stroke patients compared with sex- and age-matched reference subjects. Evaluation of post-stroke pain should be part of stroke follow-up.

Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts. Dr. Klit has received funding for congress participation from Eli Lilly and Grünenthal and research support from the Ludvig & Sara Elsass Foundation and the Velux Foundation. Dr. Finnerup has received honoraria and research support in the past two years from Grunenthal. Dr. Andersen has been a member of the advisory board for Boehringer-Ingelheim and has received lecture honoraria from Boehringer-Ingelheim, Pfizer, and Lundbeck. Prof. Jensen has received honoraria or research support from Pfizer, Grünenthal, Eli-Lilly, GlaxoSmithKline, PharmEste, AstraZeneca, and Daiichi Sankyo. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials, as detailed online in the guide for authors.


Figure 1
Figure 1. Study flowchart.
Study flowchart of stroke patients (left side) and reference subjects (right side).
Figure 2
Figure 2. Frequency of development of novel pain in stroke patients and reference subjects.
The reported prevalence of novel pain development in stroke patients (red columns) and reference subjects (blue columns). Stroke patients had a significantly higher prevalence of pain due to muscle stiffness or spasms, headache, shoulder pain, and other pain. * p<0.05, **p<0.001.n.s. not significant.

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