Inability to self-report pain after a stroke: A population-based study

Jonathan H. Smith, Kari L. Bottemiller, Kelly D. Flemming, F. Michael Cutrer, Edythe A. Strand

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


The frequency of not being able to self-report pain after a stroke has not been previously assessed in a population-based sample. We studied the epidemiology of this problem using a cohort of patients hospitalized after a stroke in Olmsted County, Minnesota, from June 1, 2008, to June 1, 2012. Overall, 52 of 388 (13.4%) individuals were unable to provide a meaningful response to either a Faces Pain Scale or Numerical Rating Scale on admission. Inability to self-report pain was associated with measures of stroke severity (P <.0001), aphasia severity (P <.0001), and level of consciousness (P <.0001). Inability to self-report pain on admission was further associated with either subsequent death during the hospitalization (P <.0001) or an inability to provide self-report on dismissal (P <.0001). Our study further defines the epidemiology of the inability to self-report pain after a stroke as being less common than previously thought. Attempts to validate observational pain scales for poststroke patients should focus on those individuals with aphasia and/or depressed levels of consciousness.

Original languageEnglish (US)
Pages (from-to)1281-1286
Number of pages6
Issue number8
StatePublished - Aug 2013


  • Epidemiology
  • Neurology
  • Pain assessment
  • Stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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