Is There A Distinction Between Tissue Damage And Neurological Pain Post-Stroke?

With Dr. Nick Housley 14th Aug, 21


Neurological pain is common after strokes, especially after thalamic strokes. The thalamus is a deep structure inside of our brain that handles a lot of gatekeeping activities concerning sensory information and coordination between other aspects of perception.

There are sensors in our peripherals that detect pain, but the pain is usually felt only in our heads. But if you are not careful in your stroke rehabilitation, that may cause tissue damage leading to pain. On the other hand, after a neurologic injury, what can happen is sensations that before injury were not painful or uncomfortable can be misinterpreted as painful. For example, hot or cold, light or pressure, or even movement can be painful. It is common after a thalamic stroke, but it can also happen after a typical stroke. It is less common, but it is possible.

Sensory Signals Misinterpretation

The sensory signals can be misinterpreted and troubling, and not only when they are due to tissue damage. Like if you cut your hand, it is going to send a signal to your brain that how it hurts. It is the same as the misperception or misinterpretation of signals that you may experience as a result of your post-stroke pain. The distinction here is the way you interact with them and try to improve them is very different.

For instance, if there were actual tissue damage, muscle strains, bone damage, or neurological damage in the peripheral nerve, you would have to modify the range of motion to prevent further tissue damage. On the other hand, if it is purely an interpretation of that information as painful, you need to recognize that pain and try techniques that can desensitize your perceptions. So it is like if you are trying to relearn how to move your arm or leg again.

Further, you have to do the same with sensory systems. By exposing yourself to low levels of senses gradually and gently, you can allow your tissues to adapt to and recognize normal sensations such as pressure, touch, cold, or heat without damaging them. It is desensitization training or acclimatization, and you have to do it carefully.

Moreover, you have to recognize which movements make you feel pain. Like imagine a sphere and quantify all those movements in the sphere that you can do without any pain. Thus, you have to be honest with yourself and identify where your pain boundaries are and work your way up to them. If you spend time in areas that might have a mild sensation or discomfort, the sensory recovery can be robust and positive, like motor recovery. It may take some time to adapt.

How Can You Use Motus Hand To Deal With Inconsistency In Movement?

The inconsistencies are complex to deal with, but you need to recognize when you can move, and you need to take advantage of it. You can use your Motus hand according to your movement. If you have leeway earlier in the day and complications at night, then you need to devote more time to rehab in the day. Also, when you are having some discomfort, you can do light touch or hand mobilization.


Out-of-range motion can damage tissues, but neurological injuries or strokes cause neurological pain, leading to a misinterpretation of sensations. However, do not push your stroke rehabilitation so hard because that can cause problems but slowly build up that reservoir that capacity to take normal sensations.

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