“My Hand Is Different”: Altered Body Perception in Stroke Survivors with Chronic Pain

Abstract

Background: Chronic pain and body perception disturbance are common following stroke. It is possible that an interaction exists between pain and body perception disturbance, and that a change in one may influence the other. We therefore investigated the presence of body perception disturbance in individuals with stroke, aiming to determine if a perceived change in hand size contralateral to the stroke lesion is more common in those with chronic pain than in those without. Methods: Stroke survivors (N = 523) completed an online survey that included: stroke details, pain features, and any difference in perceived hand size post-stroke. Results: Individuals with stroke who experienced chronic pain were almost three times as likely as those without chronic pain to perceive their hand as now being a different size (OR = 2.895; 95%CI 1.844, 4.547). Further, those with chronic pain whose pain included the hand were almost twice as likely to perceive altered hand size than those whose pain did not include the hand (OR = 1.862; 95%CI 1.170, 2.962). This was not influenced by hemisphere of lesion (p = 0.190). Conclusions: The results point to a new characteristic of chronic pain in stroke, raising the possibility of body perception disturbance being a rehabilitation target to improve function and pain-related outcomes for stroke survivors.

Role of Immersive Virtual Reality in Motor Behaviour Decision-Making in Chronic Pain Patients

“…This connection has been found to be more active in people with complex regional pain syndrome, chronic low back pain, and osteoarthritis [ 32 ]. Yet, this pathway may occur in both directions, with a change in one area influencing the other [ 78 ].…”

Is there a relationship between somatosensory impairment and the perception of pain in stroke survivors? An exploratory study

“…The experience of pain has a significant negative impact on stroke survivors' quality of life [9,11,12]. Poststroke pain (PSP) is associated with increased difficulties in physical activity, higher rates of anxiety, depression and fatigue [13], can negatively impact sleep and rest [14,15], and may be aggravated by movement and changes in body position in 20-50% of stroke survivors [10,16,17]. Pain can contribute to increases in disability due to reductions in physical function, thus adversely affecting rehabilitation outcomes [18][19][20][21].…”

“…Additionally, stroke survivors encounter other pains associated with the musculoskeletal system, emphasizing the diversity of nociceptive experiences [24][25][26][27]. Novel pains, emerging in the subacute and chronic phases, introduce an additional complexity, combining nociceptive, neuropathic, and possibly headache features [13,21]. This diversity highlights the subjective nature of pain, with varying perceived intensity, severity and symptoms.…”