When the Pain Never Goes Away
After your stroke, you’ve endured unimaginable, excruciating pain. And it just won’t go away. You may be suffering from central pain syndrome, or CPS.
As with other stroke deficits, CPS may affect normal living. Besides constant pain, you may be worried that too much movement or a change in the weather will explode into a full-blown pain episode. The pain and the worry are your constant, day to day experience.
Central pain syndrome is caused by an injured pain nerve that carries more current than an injured motor nerve. The increased signal gains the power to influence uninjured neighbor neurons that begin firing independently. The process can become so violent that the thalamus, the brain’s pain center, records “bursts” of impulses from these injured nerves. After threatening neuron death in the thalamus, the pain center “shuts down.” This is when central pain occurs. The entire pain system is acting as a nerve ending. These pain signals reach the cortex of the brain, causing unbearable suffering.
Sometimes just a light touch may cause an intense episode. Others don’t feel sensation in a limb when touched but feel extreme, unrelenting pain.
Treatments for central pain syndrome have varying degrees of success. You may need:
- Treatment that is progressive, starting with common analgesic drugs like ibuprofen, then moving to tricyclic anti-depressants or anti-convulsants. Depending on how effective these methods are, treatment may progress to increasingly strong analgesics and possibly narcotics. Finding the right medication regimen takes time.
- Neurosurgery such as deep brain stimulation in which an electrode is implanted and sends stimulation to the pain receptors.
- Psychological care. Your psyche is under assault as you navigate through the pain.
Finding the right doctor is crucial. It’s best to have one who is board certified in neurology, anesthesiology or physical medicine and rehabilitation. Most importantly, have a doctor who takes you seriously and will be available when you need help.