Central post stroke pain

This toolkit aims to support health care professions in supporting and managing those suffering with central stroke pain. Following a stroke, patients can experience a range of painful conditions, headaches, musculoskeletal pain and cramps. One significant pain problem is central post stroke pain (CPSP) which affects about 12% of those affected by stroke. It is also known as thalamic syndrome or thalamic pain syndrome, is a neurological disorder and is extremely difficult to treat. The thalamus or parietal lobe processes sensory stimuli like heat, cold and touch and as a result of damage the brain registers all stimuli as pain. It is often misdiagnosed as a musculoskeletal condition and for effective management, diagnosis and early evidence based management is extremely important. Where guidelines have included both assessment and management, the guideline link will be posted in both sections.

Assessment / Diagnosis: 
The following links will provide up to date and evidence based guidance in assessing those living with central post stroke pain. People who have CPSP sometimes describe the pain as a burning or "pins-and-needles" sensation. The pain can be widespread or focused on a specific body part, such as the hands or feet. Pain can be persistent or intermittent. Some people experience spontaneous stabbing or searing sensations that can be intolerable. Others feel a loss of sensation in the area affected. Touch, movement, stress and temperature changes can all worsen pain. Patients may also develop allodynia, which makes the body ultrasensitive to normal touch and other physical contact. CPSP can start immediately after a stroke but usually doesn't emerge until weeks, months or sometimes years later. Due to the lag time, clinicians may not associate the pain with the stroke; diagnosis can also be difficult because the symptoms of CPSP also resemble those of other pain syndromes and patients may have more than one post stroke pain. CPSP is often misdiagnosed as a musculoskeletal condition.
Management / Guidelines: 
The following links provide up to date, evidence based guidance and guidelines on managing central post stroke pain. Links presented in this section also provide guidance on what information and advice may be given to reduce the impact of the condition.
Self Management: 

This section provides links to useful information to support self management in people who live with central post stroke pain and chronic pain.

Further Information: 
This section provides website that are helpful in looking at innovative ways of managing patients with this condition and with chronic pain in general.