Central Pain Syndrome / Central Poststroke Pain, Tom Haynes, Senior PT, HCPC, Stroke Buddies 83

In this video, Senior Neuro PT Tom Haynes from Stroke Buddies explains Central Poststroke Pain (CPSP), a type of chronic pain experienced by stroke survivors. He highlights the differences between mechanical and neuropathic pain, the delayed onset of CPSP, and various treatment options, both pharmacological and non-pharmacological. Through an easy-to-understand approach, Tom underscores the importance of neuromuscular control, neuroplasticity, and the need for multidisciplinary care in managing this complex condition.

1. Introduction to Central Poststroke Pain (CPSP): Tom Haynes, a neuro PT, discusses CPSP, emphasizing the importance of understanding different types of pain after a stroke, like mechanical and neuropathic pain.

2. Mechanical vs. Neuropathic Pain: He distinguishes mechanical pain from muscle issues like spasticity, and neuropathic pain, often described as throbbing, burning, or electric sensations.

3. Pain Mechanism: Pain perception involves a complex process from the sensory input in the body to the brain, and disruption in this system can lead to central pain post-stroke.

4. Delayed Onset of CPSP: Central poststroke pain typically doesn't appear immediately but can emerge between six weeks to six months after the stroke due to neurogenesis and incorrect nerve regrowth.

5. Features of CPSP: Common symptoms of CPSP include heightened sensitivity to touch, temperature, and non-painful stimuli (allodynia), and unusual or exaggerated pain responses (hyperalgesia).

6. Pharmacological vs. Non-Pharmacological Treatments: While medication is commonly used to manage CPSP, Tom notes the limited evidence supporting non-pharmacological treatments like desensitization, light massage, and sensory re-exposure.

7. Neuromuscular Control and Pain Reduction: Increasing neuromuscular control through rehabilitation exercises can sometimes reduce pain by improving function and movement patterns.

8. Central Sensitization: Chronic pain, including CPSP, can be worsened by psychological factors like anxiety and avoidance behaviors, highlighting the importance of addressing mental health in treatment.

9. Neuroplasticity in Pain: Neuroplasticity after a stroke can lead to nerve miswiring, contributing to abnormal pain signals as new pathways don’t always connect correctly.

10. Importance of Multidisciplinary Approaches: Effective management of CPSP often requires a combination of therapies, including physical rehabilitation, psychological strategies, and sometimes pharmacological intervention.

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Videos Mentioned in this episode:

Mitch's presentation on PMF, Proprioceptive Muscular Facilitation
   • Stroke Buddies 27, Mitch Raymond, MSP...  
Tom's video on Sabeo
https://www.tmh-physio.com/our-physio...
More here
  / videos  

This is Tom's presentation on the neurological way of dealing with spasticity..
   • Bobath Neurological Approach to Spast...  
Here's the one he did on BOTOX for managing spasticity.
   • Stroke Buddies 53, BOTOX: Does It Wor...  

Tom Haynes, Senior PT, (BSc Hons), HCPC
Tom started his career in 2014 working for the NHS (in the UK). His extensive knowledge and skill allowed him to quickly achieve the grade of Senior Physiotherapist. He went on to specialize in neurological rehabilitation and participated in neurological research projects. Tom has vast experience in a number of fields, but has a particular interest in stroke recovery and neuro-degenerative diseases. He has post-graduate qualifications from the BBTA in the Bobath Approach to neurological rehabilitation. In 2018, Tom established TMH Physiotherapy which has amassed a reputation for providing an exceptional level of high-quality rehabilitation.

www.tmh-physio.com
  / tmhphysiotherapy