Feature Article

Pain after stroke: challenges in assessment and management

Michael Pollack, Christopher Chan



Pain following stroke is common, but accurate assessment of the nature and intensity of pain can be challenging. Awareness of possible pain sources, both peripheral and central, can help clinicians advocate for patients to ensure they receive appropriate management.

Key Points

  • Pain following stroke is very common, and can develop in the months after stroke onset, making GPs often the first and vital point of contact for patients.
  • As stroke can result in communication and sensory changes, assessment and diagnosis can be complex, and a high index of suspicion with careful history and examination is required.
  • Peripheral sources of post-stroke pain are more common than central post-stroke pain, although both can be present simultaneously.
  • Central post-stroke pain as a diagnosis of exclusion helps reduce the risk of missing peripheral causes of pain.
  • Individual patient risks and goals must be considered when planning investigations and management of post-stroke pain.

    Picture credit: © Photo Club. Model used for illustrative purposes only.