Priority 13 Stroke Rehabilitation and Long-term Care

UNCERTAINTY: What are the causes of different types of pain in stroke survivors, and what interventions are most effective in the prevention, treatment and management of pain? (JLA PSP Priority 13)
Overall ranking	13
JLA question ID	0106/13b
Explanatory note	Stroke survivors can experience pain which can have a huge impact on their abilities and quality of life. There's a range of different types of pain that can be common after stroke. However, there are no stroke and pain specific, up to date, systematic reviews. Despite the presence of evidence exploring pain, the most effective interventions for the treatment of pain are still unknown. Evidence is needed so that the causes of pain after stroke can be understood, and effective treatments to stop and manage post stroke pain can be developed.
Evidence	https://doi.org/10.1002/14651858.CD008242.pub3 https://doi.org/10.1002/14651858.CD004131.pub3 https://doi.org/10.1002/14651858.CD008449.pub3 https://doi.org/10.1002/14651858.CD007076.pub3 Vafadar et al. (2015) https://pubmed.ncbi.nlm.nih.gov/25685805/
Health Research Classification System category	Stroke

Extra information provided by this PSP
Original uncertainty examples	Is it normal to get pain (not headache) in the area of your head you had your stroke in after your stroke? ~ Muscle and joint pain; why does it happen? ~ I had a stroke in 2013. I still have muscle aches. Is this normal? S / I ~1216c. Muscle and joint pain in legs occurs? ~ I would like to see research about muscle weakness and pain for many years after a stroke. ~ Having made a good recovery six months after having a stroke, why has a pain syndrome now struck me so cruelly? Having had an MRI, EMG and small fibre nerve test, there are no signs or indications from this test to prove the cause of my neuropathic pain. How am I to understand that there is no explanation about my pain syndrome?
Submitted by	Stroke Survivor x 26, Carer x 3, Health/social care professional x 19, Research Recommendations x 5, Not stated x 2

Extra information provided by this PSP

Original uncertainty examples

Is it normal to get pain (not headache) in the area of your head you had your stroke in after your stroke? ~ Muscle and joint pain; why does it happen? ~ I had a stroke in 2013. I still have muscle aches. Is this normal? S / I ~1216c. Muscle and joint pain in legs occurs? ~ I would like to see research about muscle weakness and pain for many years after a stroke. ~ Having made a good recovery six months after having a stroke, why has a pain syndrome now struck me so cruelly? Having had an MRI, EMG and small fibre nerve test, there are no signs or indications from this test to prove the cause of my neuropathic pain. How am I to understand that there is no explanation about my pain syndrome?

Submitted by

Stroke Survivor x 26, Carer x 3, Health/social care professional x 19, Research Recommendations x 5, Not stated x 2

PSP information
PSP unique ID	0106
PSP name	Stroke Rehabilitation and Long-term Care
Total number of uncertainties identified by this PSP.	93 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	19/20th April 2021