Expert Answer by James Castle, M.D.
Chronic pain following a stroke is often due to increased contraction of the muscles affected by the stroke, similar to cramping. This can lead to contractures (muscle tightening that prevents normal movement) and pain in the muscles and joints.
It sounds like your dad needs the help of a physical therapist, which his doctor can help you find. A good physical therapist can teach you and your dad's other caregivers exercises to improve his range of motion. She can also recommend local therapies such as injection of botulinum toxin or the use of analgesic cream.
If your dad's pain is unbearable and doesn't respond to exercise and local therapies, oral pain medication or muscle relaxants may be necessary.
As a family member and caregiver, you can help by being vigilant about limb contractures. Try to get your dad's leg and arm moving regularly -- but stop if there's pain, swelling, or contractures. If any of these occur, check with your dad's doctor about how to proceed.
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I too have chronic pain since my stroke. They have told me I have Thalamic Pain Syndrome. Nothing so far has worked and I am not ready for narcotics, I do not want to get addicted. Therapy has had no success.
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For 20 years I have tried to find a solution to my post stroke pain. For years I was under the impression that it was Thalamic Pain Syndrome, but last year an endocrinologist said that the thalmus was not involved with my pain. These years of searching, I was 54 at the time of my stroke, have provided a lot of learning about my body and my psycological (sic) makeup. But unfortunately no answer as to where the pain is coming from or what will relieve it. I cope by keeping as busy as I can, I have mobility problems and my left arm and hand are useless. More importantly I keep my mind busy and active. Fortunately my memory is intact and my thinking facilities are clear. Word puzzles and conversation with others tend to keep the mind alert.
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My stroke 1/1/2008 gifted me drop foot and a loss of hearing in one ear with a reduction of strength on my right side top to bottom. Since my foot has a mind of its own I realy have to keep it on the straight and narrow. Many rehabists just are a controlled enviornment that some need.Some don't Some regain their control and strength through their own discipline as in my case. YOUR INPUT WAS HELPFUL. THANK YOU!
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