[NeuroNixed Craig]

I admit I am posting from absolute ignorance here. I have Googled and looked at quite a bit of information and I am having a hard time determining what the real difference between PN and Centralized Pain Syndrome?

Any insights would be very much appreciated. As I've said before, I wasn't aware of PN until coming here from the MS board out of interest.

[mrsD]

PN typically involves some damage or disease process that affects the peripheral nerves. They actually become damaged, and start sending faulty signals the brain interprets as pain.

With time, certain pain tracts become sensitized to these signals and a central pain condition may result. Phantom limb pain after an amputation, is an example of central pain.

The pain loop in the brain is pretty complex and involves several areas, and this loop is being studied quite a bit now. It involves serotonin signaling and that is one reason certain antidepressants are tried to suppress this loop.
This Medscape article explains it, but it is complex and you might have to read it several times to get a good feel for the content.
http://www.medscape.com/viewarticle/568704_9
You can join medscape for free if you don't have an ID there already.

Central pain can occur in MS:
http://www.ncbi.nlm.nih.gov/pubmed/16139182

An interesting poster came on TN forum the other day with this link:
http://www.franksherwood.com/
This gentleman claims that some peripheral pain of Trigeminal Neuralgia, can be blocked by reducing consumption of Saturated fats in the diet. It is not unlike the Swank diet for MS, but it is slightly different. Since removing saturated fat (and some of the other triggers listed) does not involve drugs, it is worth trying IMO. It is also more healthy for your cardiovascular system. How this works, remains unexplained so far, but I am including it here because it may offer you some relief.

For PN some peripheral remedies may help. We use menthol to cool burning, and Lidoderm patches for some peripheral pain.
I also use very strong magnets to block some pain.
http://neurotalk.psychcentral.com/sh...light=Lidoderm
http://neurotalk.psychcentral.com/sh...hlight=magnets

These two strong peripheral blockers may interrupt pain signals before they get to the spinal cord, and give some relief. But for central pain, they are not going to work.

Also some autohypnosis and relaxation techniques can help people not focus on pain perceptions and are worth a try. This of course is a way to intercept the pain loop in the brain. I use them frequently and have done so for many years. I credit this technique for allowing me to be RX drug free essentially for my arthritic pain and PN. (I occasionally use Tylenol or Aleve liquigels, or a tramadol at night-- I rotate use so as not to get side effects or tolerance).

Some supplements are useful. Anti-inflammatory antioxidants can help with peripheral pain, and B6 and magnesium help with muscle cramping which may lead to pain. Fish oil also helps some people.

If you have diabetic peripheral neuropathy, there are other supplements to try for that.
Benfotiamine
acetyl carnitine
lipoic acid
CoQ-10

These help some people by supporting the mitochondria which may be damaged.

Here are my supplement and drug induced PN threads.
(they are still in process, but you can get some good info from them so far:
http://neurotalk.psychcentral.com/thread121683.html

http://neurotalk.psychcentral.com/thread122889.html

It is possible some drug treatment you received in the past (like Cipro or Levaquin which are very common) has damaged your nerves --it is possible to have more than one thing going on, you know.

[NeuroNixed Craig]

mrsD,

Your information is "AWESOME!" Just this morning, and I mean like about 2:45 AM, got to some of your previous links you provided and they were very easy to understand and comprehensive in data. I am learning a lot and very quickly, thanks to your direction.

I'm looking forward to checking out these new links you've provided. I've never been on the meds you listed and my diabetes is very well under control without med support. I'm finding the Centralized Pain Syndrome may be more accurate in my situation than PN. I was surprised Monday when the doctor said I have severe,........ okay I can't remember what he called it but it is lack of sensation like I don't feel the pin prick at all anywhere, only pressure but no tactile pain. Make sense?

Anyway, thank you so much for your research and sharing what you know with us. I learned today you can only click on the "Thank you" button once. Bummer!

[daniella]

Hi I have been mentioned I think similar to this. I have PN but also RSD. My one pain doctor feels that my pain may be in my brain vs in my spine.The reason is cause I have had some treatments that are supposed to settle the pain but for me increased. So I guess if it is in the brain meds etc that help the brain process pain in a different way can be helpful. Sorry I am not as educated as many here. I saw your other post too and I saw physiatrist. It was actually before I saw my neuro at the very start of my pain. He actually preformed my first emg but then I was sent to the neurologist.Also even if I have where it is in the brain I also have PN from my testing so sometimes I think people can have dual conditions going on. I hope you find relief and answers.

[NeuroNixed Craig]

daniella,

I think as mrsD has pointed out in many threads, we are all unique but with many similarities. So to have PN and CPN is not out of the question at all. Even when mrsD post her research and experience findings for our benefit, it is clear to take what best fits the individual and not worry about the rest. None of us fits into a specific mold due to our differences.

Regarding your comment about not being as educated as many other members; I didn't realize we had to have a certain grade point average to participate. So don't even give it a second thought. I greatly appreciate you sharing your experiences and opinion. So daniella, "THANK YOU!"

[glenntaj]

--that central sensitization, which may happen after long term pain expsoure, in which there are trophic changes in brain/spinal cord neurons that keep firing even in the absence of noxious stimuli, and central pain syndrome, in which there is damage to the spinothalamic sensory relay tracts of the midbrain and stem areas, are not quite the same thing; different mechanisms are involved, though they may "feel" quite similar:

See:

www.centralpain.org

(I also wrote about this on your other thread, Craig--if I remember correctly, you have suffered from stroke, and that really makes me suspicious of central pain syndrome.)

[NeuroNixed Craig]

Yes glenntaj, I see that and have bookmarked the link which is very good. I'm still trying to figure this stuff out some what. I realize no one here is an M.D. that I know of but still the wealth of experience and knowledge is obvious. I'm still confused by your response, which way should I be looking? i.e. stroke involvement vs. central pain syndrome?

[mrsD]

Craig, one thing you can try to watch out for:

MSG (monosodium glutamate) and other things with Aspartate (nutrasweet), are neuro receptor stimulants. MSG especially.

If you avoid these two neuro-excititory substances, they will not be there to stimulate pain receptors. NMDA receptor is a pain transmission facilitator and we can try to control it some.
It is also activated by Calcium, and suppressed by magnesium.
So if you are magnesium deficient, then that pain receptor will be more active and not "shut off" properly.

And also, even if you are controlled diabetes-wise, you can still have diabetic neuropathy. It started long before you were diagnosed.

Next doctor visit request a Vit D and B12. There is a study I put up here showing Vit D restoration to normal levels, helps diabetics. (low Vit D is associated with diabetes as well). Also diabetics, even when controlled, lose magnesium thru the urine daily for some reason. So magnesium is very important to watch for this group of people.

[daniella]

Thanks sometimes I feel the experience of others is more helpful then my doctors. I am sorry you had a stroke have you googled central pain syndrom from a stroke? You may even come across someone who has had this and could give you feedback. That is part of the frustration in treatment is we are all so different and nothing is cut and dry. For me I have to experience some errors made a long the way and I know others have as well.
Glen I too was told that the longer one has pain there are the changes you state in the brain.

[NeuroNixed Craig]

I will respond within your quote using BLUE. Thank you so much for this information.

Originally Posted by mrsD

Craig, one thing you can try to watch out for:

MSG (monosodium glutamate) and other things with Aspartate (nutrasweet), are neuro receptor stimulants. MSG especially. Yes, I am very careful and attentive to MSG anyway.

If you avoid these to neuro-excititory substances, they will not be there to stimulate pain receptors. NMDA receptor is a pain transmission facilitator and we can try to control it some.
It is also activated by Calcium, and suppressed by magnesium.
So if you are magnesium deficient, then that pain receptor will be more active and not "shut off" properly.

And also, even if you are controlled diabetes-wise, you can still have diabetic neuropathy. It started long before you were diagnosed. This was exactly the question I had in mind from your last post and now you've answered it for me.

Next doctor visit request a Vit D and B12. There is a study I put up here showing Vit D restoration to normal levels, helps diabetics. (low Vit D is associated with diabetes as well). Also diabetics, even when controlled, lose magnesium thru the urine daily for some reason. So magnesium is very important to watch for this group of people. I will make sure and follow up on this with my PCP.