Raj N. Sureja, MD
In my job as an Interventional Pain Management Specialist, I treat patients with painful nerve conditions every day. Many of my patients have issues with inflamed nerves in their neck, back or extremities that cause them discomfort and affect their quality of their life. But imagine having your entire nervous system suddenly becoming chronically hypersensitive and overactivated, where almost any stimulus can be painful or uncomfortable. We call this disorder Centralized or Central Pain Syndrome (CPS). In this series of articles, I’m going to discuss this condition in detail, its causes, symptoms, how it differs from other painful syndromes, how it is diagnosed and what I can currently do to treat CPS.
What is Central Pain Syndrome? The human brain is designed to sense stimuli – both good and bad, through the nervous system and the billions of nerve cells located throughout our bodies. That’s how we ascertain that the sun is HOT! and we’d better apply sunscreen to prevent a sunburn, but the water in the pool is just the right temperature for a refreshing swim… ahhhh! This system helps to keep us safe and away from danger while enjoying life and its pleasurable sensations at the same time. When that system goes haywire and everything that touches us is painful, life isn’t pleasant.
What causes Central Pain Syndrome? The thinking used to be that the brain or brain stem had to undergo some sort of direct injury for this disorder to occur. Now, researchers are more aware that brain and nervous system function can be affected by many factors – genetics, environment, stress, childhood trauma, infection, depression, chronic pain, illness or injury or a combination of these.
There are medical issues that are known to predispose patients to CPS. They are brain tumors, stroke, spinal cord injury and multiple sclerosis. But the other concerns mentioned above must be considered, as researchers believe genetics make up 50% of the risk and environmental factors the other 50%.
CPS symptoms follow the definition of chronic pain, lasting three months or more, and is typically constant, but can be intermittent. The body is hypersensitive to stimuli that should not provoke a pain response, such as the wind blowing gently on one’s skin, a light touch on one’s shoulder or arm, the weight of a sheet on the leg, even wearing clothing may be painful; however there doesn’t have to be touch for pain to occur. One’s skin may also be itchy, numb or feel weird. The patient may also have mood swings and trouble sleeping. The symptoms may be mildly noticeable or may be severely debilitating for the patient.
In my next installment, I’ll compare and contrast CPS with two other pain disorders, Chronic Regional Pain Syndrome and Fibromyalgia. This is helpful when making a diagnosis.