Chronic Pain Whatever the cause, support for managing long term or intractable pain.


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Old 02-13-2009, 04:49 PM #1
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Default Jolt Syndrome/PTHS/Anyone diagnosed with this?

The following is from 2 references: Travell & Simons and Starlanyl & Copeland:

Jolt Syndrome, Cumulative Trauma Syndrome, Post-Traumatic Hyperirritability Syndrome, Stress Neuromyelopathic Pain Syndrome. Some of these are different names for the same syndrome. From what I read, some are related disorders.

The term "post-traumatic hyperirritability syndrome" (PTHS) was introduced to identify a limited number of patients with myofascial pain who exhibit marked hyperirritability of the sensory nervous system and of existing TrPs. This syndrome follows a major trauma , such as an automobile accident, or fall, or severe blow to the body that is sufficient to injure the sensory modulation system or brain stem. This is the system that translates impulses from different receptors in the body to the brain. The patients have constant pain, which may be exacerbated by a moving vehicle, by the slamming of a door, by a loud noise (firecracker at close range), by jarring (bumping into something or by being jostled), by mild thumps (a pat on the back), by severe pain (a trigger point injection), by prolonged physical activity, and by emotional stress (such as anger). Recovery from such stimulation is slow. Even with mild exacerbations, it can take hours to recover to previous level of pain.

With PTHS, the sensory moderating system has been modified to register extreme sensitivity to any kind of stimulus. Noise translates as pain. Touch translates as pain. Light, vibration, all these sensory signals reach the brain screaming “pain!”. People with this condition must avoid all types of strong sensory stimuli. They are a challenge to their health care team. They often can’t do any exercise and frequently can’t tolerate heat or cold.
Any additional accident or fall (even if considered insignificant) can cause an exacerbation of the hyperirritability syndrome for years. Unfortunately, with successive traumas, the person may become increasingly vulnerable to subsequent trauma.

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What I have been looking for is a research article I read about how pain lasting years (not just a fall or accident) can also conclude with PTHS; as an end-stage condition from years and years of non-relenting pain. I cannot find it again on the internet. Has anyone read something like this?I also wonder if you experience this at some times, and not so much at other times, if it is still a diagnosis of PTHS or is it something else? Sometimes, I can have lights on bright and enjoy fairly loud music, tolerate a dog barking, etc. At other times, the slightest noise can set off a chain reaction of pain in my skin, down and up my spine, in what feels like my bone marrow. Especially if it is a repetitive noise. If I sit in my living room in my lounger, and a car passes by on the street, (windows and screens and doors are closed) it can start up a sickening type pain and then every few minutes when a car goes by, the pain just seems to build and build until I can no longer stay in the living room.

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Fibromyalgia itself is a “Sensory Amplification Syndrome” where one is sensitive to sounds, smells, lights, and vibrations. That’s why it is also known as the “Irritable Everything Syndrome”. FMS sensitizes nerve endings, which means the ends of the nerve receptors have changed shape. Because of this, your brain might interpret different stimuli as pain, which makes the body start the “fight or flight” action of increasing adrenaline, Increasing heart rate, tensing your muscles, etc. So after preparing for danger, if these “geared up defenses” are not used, then our mind/body connection becomes anxious, resulting in even more pain.
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So that is what I am trying to sort out. I know some doctors propose that we do not worry about a specific diagnosis so much, that we think in terms of treating symptoms. I can agree with that some, but it also seems important to know why your life is the way it is. Sometimes it makes it easier to deal with the symptoms.

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Edited to Add: I just remember one of the things it said in the article I am trying to relocate. It said that one way to understand PTSH was to compare it to Post-Traumatic Stress Syndrome. Something trivial can trigger sensations because the pathways are there already-it is a memory of the body/mind. As in PTSD, where for example someone yelling can make you experience all of the physical sensations you had when someone was yelling and you were hurt-In PTHS, a trigger takes a shot-cut on a worn path to go right to sensation of severe pain due to the body/mind memory of it. (Now you see why I want the article-I cannot explain it right).
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Last edited by GmaSue; 02-13-2009 at 07:58 PM.
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Old 02-13-2009, 06:53 PM #2
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I just wanted to leave you a gentle hug....
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Old 02-13-2009, 07:01 PM #3
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The term "post-traumatic hyperirritability syndrome" (PTHS) was introduced to identify a limited number of patients with myofascial pain who exhibit marked hyperirritability of the sensory nervous system and of existing TrPs. This syndrome follows a major trauma , such as an automobile accident, Iwas struck by a car while riding a bicycle at age thirteenor fall, or severe blowToo many to count...I was competitive figure skater to the body that is sufficient to injure the sensory modulation system or brain stem. This is the system that translates impulses from different receptors in the body to the brain. The patients have constant pain, which may be exacerbated by a moving vehicle, by the slamming of a door, by a loud noise (firecracker at close range), by jarring (bumping into something or by being jostled), by mild thumps (a pat on the back), by severe pain (a trigger point injection), by prolonged physical activity, and by emotional stress (such as anger). Recovery from such stimulation is slow. Even with mild exacerbations, it can take hours to recover to previous level of pain.BINGO!!

I also wonder if you experience this at some times, and not so much at other times, if it is still a diagnosis of PTHS or is it something else? Sometimes, I can have lights on bright and enjoy fairly loud music, tolerate a dog barking, etc. At other times, the slightest noise can set off a chain reaction of pain in my skin, down and up my spine, in what feels like my bone marrow. Especially if it is a repetitive noise. If I sit in my living room in my lounger, and a car passes by on the street, (windows and screens and doors are closed) it can start up a sickening type pain and then every few minutes when a car goes by, the pain just seems to build and build until I can no longer stay in the living room.Absolutely!!

Off to do some research...
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Old 02-13-2009, 07:02 PM #4
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I have had myofascial pain several times... specially when Im under stress...
And about repetitive sounds... they drive me nuts !!!!!!!!!!!!

now, to determine what problem I really have will be nice but difficult I guess... hum... I will stay with the "Irritable Everything Syndrome" idea... It fits me perfectly !
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Old 02-13-2009, 08:03 PM #5
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(((GmaSue))) I'm so sorry.

Well, when you're feeling up to it, we'll have to meet and have a gentle hug in person.
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Old 03-03-2009, 09:29 AM #6
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Default PTHS -Post Trauma Hyper- Syndrome -- "jolt' syndrome

Sue...
read & replied to your post @TBi/PCs forum - about these 'syndromes' -
i'd not heard of before.

Hyper-irritibility is listed Sx of PCS ~Post Concussive syndrome
'common' occurance for many after TBi ~Traumatic Brain Injury.

since my TBi accidents i've experienced hyper-irritability -- what i call my "Hyper-Sensitivities" -- to noise, sound, vibrations; Light; smells & other sensory stimulation--'sressors' that can generate dis-stress, pain.

Stress most def worsens
but what's now 'stress' is much ,
with many potential 'triggers' erratically affecting
as others shared how many things {'stressors'-triggers ] that "shouldn't" or didn't before trauma now "bother"
Unpredictably, intensely-- affecting Life, living in so many ways


Sue
you presented many questions, issues
similar , familar....
i need to re-read your post (sorry another affect of Tbi/PCs for me is Cognitive --memory, problems writing, thinking, more ... my Dr blames chronic intractable pain....

Pain--in its many manifestations--
DX's, 'names' --reasons, causes, potential treatments, interventions, more
Hope to continue discussions and address more details soon, and that others will continue to share thoughts, experiences, insights, info....


i was Dx'd w/ myofacsial pain & fibro { agree FMS is the great Exagerator/Exacerbator

Central Sensitization - IMHO - factor in this and other chronic pain disorders i'm trying to understand, and deal with...
it's been , and continues, to be a long strange trip...




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Last edited by pono; 03-03-2009 at 10:13 AM. Reason: add
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Old 03-05-2009, 05:57 PM #7
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Hello:

While reading through this thread ... had a thought!!! ( amazing as that may seem on some days!). I've had considerable training and experience working with individuals who are diagnosed with Sensory Integrative Disorder/Disfunction. There seems to be an awful lot of similarities in how various types of sensory input can result in confused/unusual sensory responses. The brain can be such a wondrous thing and a real pain in the .... neck! when it gets things messed up or starts to misfire. I had a student who's brother took him to a heavy metal concert. When we asked him how it went afterward he kept saying the music "burned" ... someone tried to correct him and tell him he meant the music was "loud" ( the student also had an Autism Spectrum Disorder and everyone loved to correct the poor guy when they "thought" he was using the wrong vocabulary ) ... but he was insistent that the music burned. After while he got very frustrated and said "It burned like when you put your hand on the stove." ( something he had actually done and could relate concretely to the experience ). The stimulous of the music obviously managed to stimulate the pain center in his brain.

I'm just wondering if the two syndromes could be related or may be, potentially, the same disorder?

Just a thought and possibly another area to research under. I'd be interested in hearing your thoughts.

Take care all, be safe and well: Kefrin
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Old 03-09-2009, 11:54 AM #8
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Thank you all-you are good "thread buddies". Comparing notes can help us learn what we have-or how to deal with it-

Here's a clue maybe. Even though a car passing by outside my house can trigger pain-it struck me while we were on a walk, that passing cars never
hurt. So I am trying to figure out the difference.

So far, these are the only difference I have come up with:

Outside on a walk:
1. I am more relaxed.
2. I know the car is coming-I can see it.
3. Even if it comes from behind-I expect cars to be coming along-so it doesn't ambush me. I can get ready for it. (Not in a conscious way-but maybe in an automatic way.)

The expectation or "preparing" for something could also explain why light will not hurt as much if you see someone turn on the light as if it is just suddenly lighter in the room and you didn't know it was coming.

"Staying ready" for stimuli creates stress, though. And the more stressed you are, the more stimuli can hurt.

Things being mellowed or smoothed out is not the total answer, though. For example, the only way I can stand to watch TV much of the time is to curf. ckick, ckick, ckick. Changing the channel breaks the pain for a second and nerve pain goes down-then starts building-until I click again. The jerkiness (or lack of continuity) in that instance is the "fixer".

Just had a wild thought-what if I tried a hand held clicker (like a dog training clicker) and tried to click pain away by interrupting it as it starts to build. hmmmm.
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Old 07-28-2009, 01:46 PM #9
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