Chronic pain prevalence and severity associated with stroke survivorship

Chronic pain is a common complication following stroke. However, most studies assessing its prevalence among stroke survivors include relatively small samples and lack include comparator groups from the general population.

This cross-sectional study compares prevalence and severity of chronic pain according to history of stroke survivorship by utilizing a large, nationally representative sample of United States adults.

We analyzed data from adult respondents to the 2019, 2020, 2021, and 2023 National Health Interview Surveys (NHIS). Stroke survivorship was identified based on respondent self-report, and chronic pain was identified as experiencing pain most or every day for the past 3 months. Secondary outcomes included pain severity and pain impact on life, work, and family.

Among 105,179 survey responses, 3.6% reported a history of stroke. Nearly half of these respondents (48%, 95% confidence interval [CI]: 0.45, 0.50) reported chronic pain, in contrast to only 21% (95% CI: 0.21, 0.22) of respondents without a stroke history. Stroke respondents were more likely to suffer from chronic pain (odds ratio [OR]: 1.46, 95% CI: 1.32, 1.62), report higher pain severity (OR: 1.40, 95% CI: 1.28, 1.53), and higher impact pain (OR: 1.77, 95% CI: 1.59, 2.00) compared to those without a history of stroke.

Future research on stroke and chronic pain should explore the mechanisms of chronic pain development to establish more targeted therapeutic interventions. Additionally, the association of stroke and chronic pain indicates that treatment should involve collaboration with multidisciplinary teams to promote early rehabilitation to reduce pain and disability.