IT WOULD BE HELPFUL TO HEAR A DESCRIPTION OF THE VARIOUS PAINS YOU MENTIONED. AS DR CASTLE MENTIONED. IF ITS MUSCLE OR SPASTICITY PAIN THEN ITS A MUST TO GET PT WORKING ON THE PROBLEM. IF ITS THALAMIC PAIN/CENTRAL PAIN SYNDROME ITS A WHOLE OTHER BALL GAME. HERE IS THE CURRENT DEFINITION USED BY OUR GROUP. BY THE WAY.... THE THALAMUS DOES NOT AWLAYS HAVE TO BE THE DAMAGED AREA. BUT YES, IN MOST CASES WITH STROKE IT IS.
REMEMBER YOU ARE NOT ALONE IN THIS STROKE AFFECT. THERE ARE PEOPLE WHO UNDERSTAND.
CENTRAL PAIN SYNDROME
A neuropathic pain with various names.....In an effort to get everyone on
the same page term we use is
Central Pain Syndrome
We will often use "CPS" for short.
Synonyms: Also known as
Central Post-Stroke Syndrome
Posterior Thalamic Syndrome
Thalamic Hyperesthetic Anesthesia
Thalamic Pain Syndrome
Central Pain Syndrome is a neurological condition.
24/7 Sensations can affect us all differently, in different places on our
bodies, and at different levels of pain and suffering.
Extremely difficult to diagnose.
Often sending the patient to many doctors to find one that believes in
Finding a doctor who is willing to treat and work to find relief for the
person that suffers with this savage pain becomes a miracle in the mind of
those that suffer.
Central pain syndrome occurs because of injury to central nervous system...
CPS can be caused by stroke, multiple sclerosis, epilepsy, Parkinson´s
disease, toxins, tumors and trauma to brain or spinal cord, any diseases that
eventually reach the central nervous system.
It can be a steady, sometimes deep burning, aching, cutting, tearing,
pressing, lacerating mixture of pain sensation.
Pain may be moderate to severe in intensity.
CPS may be described
as weird sensations like Burning: "A chemical, not a purely physical burn"
, "bone cold", "wet" sensations, tingling, a "pins and needles", a "
ballooning" sensation, throbbing, the feeling of a dental probe on a raw nerve,
Intense skin reactions
can accompany these symptoms, such as burning, stretching, tightness,
itching, or a crawling feeling.
CPS can be aggravated by any light touch such as the feel of cloth on skin
making dressing an ordeal, as can the touch of a sheet or blanket.
The touch of a loved one, may overwhelm the brain with the pain from CPS.
Gut pain, stomach nausea and vomiting can be a part of CPS.
The hands, feet, head, and trunk can be affected with a numbness that is
painful, and does not offer any relief, only adding to the pain.
CPS can begin from day one of the stroke/injury or can take months, even
years to make it's appearance. Central Pain Syndrome can be a life
It can often cause depression, anxiety, anger, frustration and
When a person rates the pain as a 9 or 10 on a pain scale, and there seems
to be no relief in sight, with no hope or understanding or support from
family and professionals, they may even come to feel that suicide is the only
Triggers and Sensitivity reactions
Stress, anger, depression.
Movement, daily activity, ROM exercising, tiredness.
Exposure to sun, rain, cold, snow, breezes, AC, drafts, unseen sun flare
activity, barometer changes.
Environments of warmer and cooler from the particular person´s comfort
Added pain or swelling.
Light touches of another person, blanket, clothes, splints.
Yawning and other reflexive involuntary movements such as sneezing, being
startled, loud noises, bright lights and even vibrations as from riding in a
Light sensitivity for the eyes,
noise sensitivity for the ears can be triggers for higher pain levels.
7 Types of pain sensations
Any or all of these pain types can overlap. A person could have one or all
of these that can come and go as time passes.
- Burning dysesthesia:
A mixture of pain sensations in which persistent light
touch is perceived as a thermal sensation. There are four overlapping
"A chemical, not a purely physical burn"; "A mentholated burning"; burning
it up with fire and acid".
"Like touching dry ice"; "bone" cold.
Wet and uncomfortable underneath the burning."
Motor or Kinesthetic Dysesthesia:
A feeling of cramping and contraction
associated with burning. "A terrible fatigue in my muscles, "A feeling of
drawing, pulling, crushing."
Heightened response to a noxious stimulus.
Pain from a very mild stimulus. Can also describe referred pain.
Can relate to touch, location, temperature or muscle loading.
"Light touch from clothing becomes unbearable after a few minutes,
like an awful sunburn"; "Paper laid on the legs begins to burn unbearably
after a minute or so."
Touching the face might show up as burning on the outside of the forearm.
Sitting long enough for the skin to burn can become burning out to the side
on the legs
Picking up a warm drink, it feels hot in the hand. Warm ambient
temperature sensitizes the skin so that all the other pain features appear
Movement makes the body unbearably sore. The day after exercise, the body
might have awful feelings of lactic acid buildup. Lying in bed can feel like
sleeping on rocks.
Shooting or 5. Lacerating:
Sharp stabbing pains with an electrical quality.
A very common type in which circulation feels compromised. The feeling of
pins and needles in parts of the body.
Feeling of fullness, burning, cramping, nausea or distention.
Central Pain Syndrome
can require a multidisciplinary team of pain specialists.
Anesthesiologists, neurologists and neurosurgeons, rheumatologists,
psychiatrists, physiatrists, family doctors, nurses, physical therapists,
acupuncturists, massage therapists, and chiropractors all
have different methods of treating chronic pain.