This site is dedicated to Central Pain, which can result from conditions such as stroke, spinal cord injury, multiple sclerosis, syringomyelia, syphilis, cancer, or any other injury to the central nervous system. Injury may occur due to direct injury to the nerve, or by from any situation which compromises blood circulation to the nerves of the central nervous system. Much of the information here also applies to nerve injury to the peripheral nerves that occurs in diabetes, crush injuries, direct nerve damage from trauma or exposure to toxins, AIDS, and many other conditions.

Doctors used to think that pain was fairly simple. They viewed it as a straightforward situation similar to banging a drum; if you hit the drum, it makes a noise. Bang the drum harder, and it makes a louder noise. Bang on a different drum, it makes a slightly different noise. Pain was a simple message to the brain to notify it of a noxious stimulus, and everyone thought they had a pretty good understanding of its nature.

Modern pain researchers now understand that pain is infinitely more complicated than the “bang the drum” analogy. There are at least seven identified pain centers in the brain. Contrary to previous thought, the central nervous system is able to feel pain under certain conditions. Severe pain can be detected through imaging studies, such as PET scans, by measuring differences in blood perfusion in certain areas of the brain.

Tasker realized that the treatments for normal pain would not work for nerve injury pain. He realized that nerve injury pain is different and behaved differently in the body. Tasker divided pain broadly into two categories; normal pain, or pain that anyone is capable of feeling, and nerve injury pain, which only occurred as a result of nerve damage, the result of which is peculiar pain sensations that no one without nerve damage can experience. It sounds like a small step, but it was a tremendous breakthrough in understanding to realize that pain may feel differently if the injury is to the nerve itself.

Another of Tasker’s breakthrough discoveries was that pain sensations peculiar to Central Pain could occur no matter where in the central nervous system the injury occurred. The symptoms can vary from patient to patient, but they may include a type of strange burning that can be present all the time, and which could be made worse by stimuli which normally would not cause pain, such as the light touch of wearing regular clothing.

If you are dealing with a patient who may be suffering from nerve injury pain, it is important to learn as much as possible. Nerve injury pain is very different in nature from normal pain, and may contradict everything you were taught about pain in your training. In addition to the resources available on this site, here are just a few important resources to serve as a starting point:

• “The Management of Pain: Second Edition” by John Bonica
• “The Textbook of Pain” by Patrick Wall, Ron Melzack, et al
• “Pain” the official journal of the IASP