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Brogårdh C.1,2, Gard G.1,3, Lindgren I.1,2
1Lund University, Dept of Health Sciences, Lund, Sweden, 2Skåne University Hospital, Dept of Neurology and Rehabilitation Medicine, Lund, Sweden, 3Luleå University of Technology, Luleå, Sweden
Background: Shoulder pain is one of the most common pain locations after stroke and affects between 50% and 80% of all stroke survivors with persistent upper extremity disability. Even though shoulder pain is common after stroke no study has investigated how the persons perceive that shoulder pain influences daily activities, participation and life satisfaction or effects of interventions. An increased knowledge could help the clinicians to plan more appropriate and individualized rehabilitation interventions.
Purpose: To describe experiences of shoulder pain after stroke, how the pain affects daily life and perceived effects of interventions.
Methods: A total of 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke were interviewed. A semi-structured interview guide was used covering the following areas: i) experience of shoulder pain (pain onset and characteristics, changes over time); ii) the impact of shoulder pain on function, activity, participation and life satisfaction (pain situations, effects of pain in daily life); and iii) interventions (with perceived good or bad effects). All interviews were transcribed verbatim and analyzed by content analysis. Meaning units were identified from the data and labelled with codes. The codes were then sorted into subcategories and categories to answer the study aims.
Results: Three categories emerged from the analysis. In Multiple pain characteristics an insidious pain onset was reported. The pain could exist both day and night and was located around the shoulder girdle but also had radiation to the arm and hand. An explanation of the pain was seldom given by the professionals. In Limitations caused by the pain it was described how the pain negatively influenced personal care, household activities and leisure, but also could lead to emotional reactions. In Multiple pain interventions with various effects a variety of interventions were described. Self-management interventions with gentle movements were perceived most effective. A restraint attitude to pain medication due to side effects was reported.
Conclusion(s): Shoulder pain after stroke can lead to a variety of pain characteristics. As the pain is complex and may affect many important areas in a persons life, multidisciplinary rehabilitation interventions are important to consider. In the future more efficient interventions need to be developed in order to reduce the shoulder pain.
Implications: Shoulder pain after stroke is complex and may influence many important life areas, which should be considered in the rehabilitation. Gentle movements may be most effective to reduce the shoulder pain.
Funding acknowledgements: Fundings from the Swedish Stroke Association, the Norrbacka-Eugenia foundation and the Academy of Care Science at Skåne University Hospital.
Topic: Neurology: stroke
Ethics approval: The study was approved by the Regional Ethical Review Board in Lund, Sweden (Dnr 2014/657).
All authors, affiliations and abstracts have been published as submitted.
