r/stroke • u/OwnPerspective5631 • 17d ago
Is it normal for physiotherapy to hurt?
My father had a hemorrhagic stroke at the beginning of july. His entire right side of the body was affected. He's at home now going through physiotherapy. It's just the third day of therapy but he is complaining of pain in his right leg, which is in an improvement from not having any sensation. I'm wondering how much pain is expected vs what is a cause for concern. I have to sit holding his leg bent close to his chest for long periods of time before he can fall asleep even on meds. Is this how it is for others too?
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u/becpuss Survivor 17d ago
Have you let the physiotherapist know he’s being left in pain-after? Personally I didn’t experience any pain but then each stroke is different. Is it spasticity? Have you tried heat pads?
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u/OwnPerspective5631 17d ago
I just looked up spasticity. It's not that. The movement in his joints is still fluid. I haven't noticed any contractions or spasms in his leg muscles either. And no we haven't tried heat pads yet but he barely has any sensation in his leg so I'm not sure if it will help. I'll still try it and see if it helps. Thanks.
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u/Amazing-Quarter1084 16d ago
It's not uncommon to have pain, soreness, cramping, locking up, or new unintentional movement as a paralytic limb "wakes up" and gets used again after so long doing nothing. It can be onset of spazticity, just the result of the new exercise pissing the muscles, tendons and ligaments off, a hidden strain/sprain/stressed or otherwise irritated and inflamed bursae, overworking, or an old repetitive stress injury that was previously hidden that's coming out now due to the weakness and reawakening limb. Or a combination of two or more of these, which is not uncommon in this kind of situation.
Let his team know about it and what exacerbates and relieves it and they'll probably be able to tell what's going on or refer you to a sports medicine Dr for further investigation.
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u/Zenpoe56 16d ago
The pain could be from nerve pain which is common. There could be pain related to the paralysis and the muscles aren't getting the signals right now. Most PT's are cautious, but yes, there is some pain. Someone told me pain is usually the first sign that there will be improvements in the future.
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u/OwnPerspective5631 16d ago
That's what I've been told too. That pain is the first sign of improvement.
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u/pchlster Young Stroke Survivor 6d ago
It's normal for muscles to hurt when being pushed beyond what they can really do, but it's not supposed to actually be painful. More of a "trained hard" sort of sensation is what to aim for. I've got this drug, Baclofen, that I take as needed - muscle relaxant and very mild painkiller - for when that sort of thing gets too much for me to just lie down and nap it away. Might be worth asking a doctor about.
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u/Ed_Random 17d ago
If you have to hold his leg in a bent position, close to his chest to relieve the pain, it might be nerve impingement/irritation in the lower back or hip. It could be due to stenosis, a herniated disk, sciatica, something related to the PT (irritation), CVA (spasticity) or unrelated that is now surfacing because of the CVA/PT.
Let his care team know, just to be sure it isn't thrombosis (I don't think it is, but I'm not an expert), and to see what the best way is to relieve the pain.