Central pain syndrome (CPS) is a neurological condition that affects your central nervous system (CNS), which includes your brain, brain stem, and spinal cord.
It can happen when you've had or live with strokes, multiple sclerosis, Parkinson's disease, brain tumors, limb amputations, brain injuries, or spinal cord injuries. It can develop months or years after injury or damage to your CNS.
What Causes Central Pain Syndrome (CPS)?
Health conditions that injure your brain or spinal cord, or ones that trigger ongoing pain, are the main causes of CPS. But you probably won't notice right away.
"Most patients won't have this pain syndrome arise right away; it can be months after. That's what makes it tough to diagnose," says Anthony Giuffrida, MD, director of interventional spine and pain management at Paley Orthopedic & Spine Institute in Florida.
Which conditions or injuries can lead to CPS?
CPS can result from several conditions and injuries, including:
- Brain cancer
- Noncancerous tumors
- Concussions
- Traumatic brain injury
- Multiple sclerosis
- Parkinson's disease
- Epilepsy
- Seizures not caused by epilepsy
- Infection
- Spinal cord injuries
- Stroke
Other conditions linked to CPS are:
- Arthritis
- Back pain
- Cancer
- Chronic fatigue syndrome
- Ongoing pelvic pain.
- Complex regional pain syndrome (CRPS)
- Fibromyalgia
- Irritable bowel syndrome
- Joint pain
- Migraine
- Nerve damage to your arms or legs
- Shingles-related nerve damage and pain
- Temporomandibular joint (TMJ) disorders
Genes
If your parent has CPS, your risk of having it is eight times higher than someone without a family history of it. Researchers still don’t know which gene changes are responsible for this higher risk.
What Are Symptoms of CPS?
CPS causes you to have a mix of pain sensations. The most noticeable symptom is often a constant burning feeling that may worsen with a light touch.
"It could be to the point where you can't even use sheets because it hurts too much," Giuffrida says. "I've even heard of cases where a cold breeze will hurt so much that the patient can't be out in the winter."
The biggest difference between CPS and other pain syndromes is that you can't pinpoint it, he says.
"If someone has chronic pain in the lower back, they're going to very easily tell you, 'Hey, my back hurts.' Central pain syndrome is an ambiguous pain that can be anywhere. It can cause problems all over the body depending on what part of the brain or spinal cord is damaged."
With CPS, you may feel pain as:
- A sharp or stabbing sensation
- Itchiness
- Numbness or tingling
- Pain deep in your muscles or tissue
- Achiness
- Pressure
- A cutting feeling
Are the symptoms of CPS constant, or do they come and go?
For most people, the pain of CPS stays with them. For others, it may come and go. Pain often increases with temperature changes, especially when it's cold. You can lose feeling in different places of your body, including distant areas such as your hands and feet.
How Is CPS Diagnosed?
Doctors usually diagnose it by asking about your medical history, doing a physical exam, and learning more about your symptoms. They'll want to know:
- Where you feel pain
- What the pain feels like
- The timing of your pain
- Whether certain things, such as temperature, change your pain
- If you have injuries or health conditions that could be causing pain
- If you have other symptoms besides pain
What tests or imaging scans are used to identify CPS?
Imaging studies, such as a CT scan or MRI, can help doctors pinpoint which area of your nervous system is damaged. Other tests may include:
- Electroencephalography (EEG), which measures activity in your brain
- Magnetoencephalography (MEG), which measures magnetic fields generated by your brain's electrical currents
- Positron emission tomography (PET) scan, which shows how your brain is working in real time
What doctors or specialists diagnose central pain syndrome?
Your family doctor, neurologists, pain medicine specialists, and rheumatologists may all be involved in diagnosing CPS.
How Is CPS Treated?
Although there's no cure, treatment can help manage your symptoms.
What medications are commonly used for CPS pain relief?
Pain medications often offer little or no relief. But some antidepressants and anticonvulsants may help. Your doctor may prescribe:
- Anti-seizure medication (gabapentin or lamotrigine)
- A type of antidepressant called SNRIs (duloxetine and venlafaxine)
- Tricyclic antidepressants (amitriptyline or nortriptyline)
- Pain relievers applied to your skin (lidocaine)
What lifestyle changes can help manage CPS?
Taking care of your physical and mental health is crucial. Experts suggest:
- Physical therapy for better strength, flexibility, and coordination. Be sure to avoid activities that worsen your pain.
- Mental health therapy, such as cognitive behavioral therapy (CBT). It can help deal with the emotional and mental challenges related to CPS.
Takeaways
- CPS affects your central nervous system.
- It usually happens when you have another condition affecting your brain and spinal cord, or a health issue that causes chronic pain.
- CPS pain can be constant or come and go.
- Treatment often includes medication, lifestyle changes, and physical therapy.
Central Pain Syndrome FAQs
What's the prognosis when you have CPS?
Early diagnosis and treatment are key to a good outlook. If doctors can pinpoint the cause of your CPS, they're better able to treat or even reverse it. Otherwise, they can manage your symptoms to stop them from worsening.
Is CPS a disability?
Sometimes. It can cause long-term disability if not managed.
Can relaxation techniques ease the symptoms of CPS?
Studies show relaxation techniques may help ease pain related to CPS, especially when used with other treatments.
What role do diet, sleep, and stress management play in managing CPS?
They matter a lot. A healthy diet of anti-inflammatory foods, such as fruit, vegetables, and fiber, along with quality sleep and stress management, can relieve pain and improve the quality of life with CPS.
