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Is there anything that will help relieve my dad's pain after his stroke?

12 answers | Last updated: Aug 31, 2014
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Q
A fellow caregiver asked...
My dad had a stroke two years ago, and he's got chronic pain in his stroke-affected arm and leg. What can be done to relieve the pain?
 

Answers
Caring.com User - James Castle, M.D.
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James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.
83% helpful
answered...

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 See also:
How can I be sure that a headache after a stroke isn't a ministroke, or TIA?

See all 480 questions about Stroke
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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75% helpful
A fellow caregiver answered...

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.

 

45% helpful
Pawnee answered...

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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An anonymous caregiver answered...

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!

 

90% helpful
Mary Simpson answered...

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.

HUGS MARY

http://www.centralpain.org

http://health.groups.yahoo.com/group/CPS_ALLIANCE/

CENTRAL PAIN SYNDROME A DEFINITION

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 Dejerine-Roussy Syndrome Central Neuropathy Posterior Thalamic Syndrome Retrolenticular 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 their suffering. 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.

Causes: 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.

Sensations: 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, even metallic.

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.

Intestinal reactions Gut pain, stomach  nausea and vomiting can be a part of CPS.

Numbness 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.

Onset 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 threatening condition: It can often cause depression, anxiety, anger, frustration and hopelessness.. 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 way out.

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 zone. Added pain or swelling. Light touches of another person, blanket, clothes, splints. Sudden movements: Yawning and other reflexive involuntary movements such as sneezing, being startled, loud noises, bright lights and even vibrations as from riding in a car.

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.

  1. Burning dysesthesia: A mixture of pain sensations in which persistent light touch is perceived as a thermal sensation. There are four overlapping subtypes.

Burning: "A chemical, not a purely physical burn"; "A mentholated burning"; burning it up with fire and acid".

Cold: "Like touching dry ice"; "bone" cold.

Wet:   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."

  1. Hyperpathia: Heightened response to a noxious stimulus.

  2. Allodynia: Pain from a very mild stimulus. Can also describe referred pain. Can relate to touch, location, temperature or muscle loading.

Touch: "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."

Location: 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 and behind."

Thermal: 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 more easily."

Muscle loading: 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.

  1. Shooting or 5. Lacerating: Sharp stabbing pains with an electrical quality.

  2. Circulatory: A very common type in which circulation feels compromised.  The feeling of pins and needles in parts of the body.

  3. Peristaltic: 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.

 

50% helpful
Barbaramae answered...

My partner just had a stroke and he was told he had CPS as well and was given medication to help the pain and thank goodness it really helps him until we find out what caused his stroke. They are doing an MRI next week and that should shed more light on the cause. His pain was so great that he could not do anything but hold his head. He was having sharpe pain in the head, constantly. They prescribed other meds but they did not help until they gave him a low dose of morphine. I think 15mg until he gets the MRI done. He seems so much better now, he can eat and talk and sleep ok. Very big difference now that he can control the pain. Barbaramae

 

100% helpful
Mary Simpson answered...

HI, NOT ALL CPS COMES FROM THE THALAMUS AREA. IT IS VERY RARE BUT CAN BE FROM DAMAGES TO OTHER AREAS OF THE BRAIN. REMEMBER WE AT CPSA ARE HERE FOR YOU IF YOU WANT TO BE IN A GROUP OF PEOPLE WHO UNDERSTAND WHAT YOU ARE GOING THROUGH AND MIGHT GIVE YOU IDEAS THAT NO ONE HAS TOLD YOU.

ALSO.... UP TO 20% OF STROKES CAN END UP WITH CPS AS A LONG LASTING AFFECT.

AS FOR FINDING THE "CPS" DX. 5% ARE TOLD THEY HAVE CPS, 5% FIND OUT IN THEIR RESEARCH THAT THIS FITS THEM, AND 5% NEVER KNOW WHY THIS IS GOING ON IN THEIR LIFE. SO SPREAD THE WORD IF YOU RUN ACROSS A STROKEE WHO NEEDS ANSWERS. AND BE GRATEFUL YOU HAVE A TERM AND KNOW WHERE TO SEEK ANSWERS. HANG IN THERE YOU ARE NOT ALONE. HUGS MARY

 

100% helpful
knowthesigns answered...

TIA reasons to be early sign that stroke is on its way. TIA can serve as WARNING SIGN for the approaching danger of disaster to the brain. It is time to use the brain to prevent the stroke. TIA is called "little stroke", because little chunks of clott are breaking off from a big clott stuck somewhere down the "river". The stroke will be prevented by finding the source of the little flying chunks. Alcohol is the worst because it dissolves the big clott which can suddenly disloge and causing stroke. Alcohol causes the brain cells to be in a drunkin stupar. Drunk brain cells can not think. "From little things big things will one day come." It is wise/sincere/respecful/caring/humble/peaceful/thankful to recognise and seek help from that who created the brain.

 

100% helpful
Mary Simpson answered...

TO Barbaramae. I AM SO GLAD THEY GOT AT HIS HEAD PAIN AND FOUND SOMETHING TO GIVE HIM SOME RELIEF.
BUT I MIGHT ASK WHY THEY ARE TAKING SO LONG TO GET MRI VIEW OF WHAT IS HAPPENENING? HE COULD BE HAVING THE PRE PAIN OF A HUGE STROKE. . HEAD PAIN IS FAIRLY RARE IN CENTRAL PAIN.... AND HAVING THAT MUCH HEAD PAIN SO EARLY ON WOULD SCARE ME BEYOND WORDS. DO UP DATE US AS YOU FIND OUT WHAT THEY FIND OUT. ANDHE IS IN MY PRAYERS THAT NOTHING BIGGER AND WORSE IS GOING ON THEN CENTRAL PAIN.

THANKS FOR LOOKING OUT FOR HIM. HUGS MARY

 

33% helpful
leyla answered...

I recently visited my aunt, she had a stroke couple weeks ago and her right side is disabled, she had so much pain in the affected arm and leg that she would cry a lot! I brought her wood lock medicated oil and she is using it since! Miraculously her pain is totally gone, i taught to post this so it can help someone as well, even one of the therapists couldn't believe it she took the name to search it online for her mom! you can buy it on www.ebay.com , its yellow box with Chinese head printed in the front Wong to Yick, thanks

 

100% helpful
Mary Simpson answered...

ARE YOU AWARE OF THE WONG TO YICK INGREDIENTS? NOT SO SURE I WOULD US THAT FOR MY STROKE PAIN. ESP. IF USING MORE THEN A DROP.
IF YOU ARE IN A MMJ STATE. PUTTING MJ TINCTURE IN ANY LOTION WILL HELP HER. HUGS. MARY WONG TO YICK Per 50 milliliter: Camphor 4.5g Menthol 17.0g Methyl Salicylate 15.0g Turpentine Oil 6.0g Other ingredients per 50ml[1] Radix Dipsaci 0.103g Rhizoma Curcumae 0.062g Cortex Eucommiae 0.083g Radix Saposhnikoviae 0.103g Flos Carthami 0.062g Radix Angelicae Pubescentis 0.103g Rhizoma Drynariae 0.083g Rhizoma Corydalis 0.062g Radix Clematidis 0.062g Radix Zanthoxyli 0.103g [edit]

 

sandrakg answered...

Hi I found that my father was actually having tactile hallucinatins and the only way I could stop his pain was by using haloperidol. He takes .5 at night and .5 in the morning. Unfortunately the only way I discovered this was when he was treated for final stage vascular dementia caused by his first stroke, the major haemorrhage in the occipital lobe. He is now in a nursing home but is pain free at the moment from the dreadful pain in his leg. Hope this may put someone on a path to researching 'tactile hallucinations' which are caused by the damaged brain part of the stroke. Regards Sandra

 

 
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