Does sensory perception pain ever go away?

1 answer | Last updated: Sep 12, 2016
Serenitywalker asked...

I had a stroke on May 31, 2013. I have had physical, occupational and speech therapy and have been discharged from rehab, but my neurologist sent me for an EMG on Aug. 6th. My weakness from the stroke has really improved with rehab, but these weird sensations and pain persist. What good will the EMG do since it measures muscle weakness? Is there anything my neurologist can do to help relieve these sensations of burning, cold, itching and pinching? He said he thought I had diabetic neuropathy, but it came on suddenly with the stroke. I didn;'t have any of these problems prior to the stroke. I don't want to take medication for pain the rest of my life.


Expert Answers

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

Your pain does sound likely to have been caused by the stroke but the class of the pain would still be the same. The medical name for sensory perception pain is "Neuropathic Pain," which is when something is wrong with the nerve and that creates pain.

There are a variety of treatments for neuropathic pain and each of them work in about 50-70% of patients. The sad point is that once the nerve is damaged, in this case by the stroke, there is a high liklihood that, at least some of that pain will remain. Every year some people see their pain go away, but my advice is to work with your doctor to try and MANAGE the pain. This can be done with certain antidepressents like nortriptyline and similar drugs and Cymbalta. Other drugs that can help are gabapentin and pregabalin. There are other non-opioid drugs that can help but many require regular blood tests which those listed above so not. I understand that people do not want to take pain medicines and it is fine to take the lowest doses that allow you to live your life. If however, the pain severely impacts your quality of life, then it is important to treat the pain. If the pain improves, then you can always taper the doses of the medications.

Post stroke pain can be caused by muscle contractures in the areas affected by the stroke. In that case it is a good idea to see if a physical therapist can help with the cramping muscle pain.