Central pain syndrome is a chronic neurological condition that affects how you feel pain. It can happen because of damage to your brain or spinal cord. It also can happen when chronic pain alters how your nervous system handles pain signals. This condition often has severe effects and is often difficult to treat.
Central pain syndrome (CPS) is a chronic condition where you feel ongoing pain because of an issue with your nervous system. It can happen because of damage to your brain or spinal cord, or because of a malfunction in your nervous system that can happen when you live with chronic pain.
When central pain syndrome happens because of an injury or damage, the affected brain or nerve cells malfunction and send constant pain signals. Central pain syndrome from chronic pain happens because your nerve cells become too sensitive to pain signals. That can cause them to send pain signals mistakenly or to wrongly interpret other signals as painful.
This condition is often difficult to treat. Pain relievers, even stronger drugs like opioid medications, commonly won’t bring relief from the pain. But experts have uncovered newer treatment methods and medications that can often help people with this condition.
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CPS and fibromyalgia aren’t the same thing, but they’re often connected. Fibromyalgia is a chronic pain condition that affects your joints and muscles. People with fibromyalgia are much more likely to develop central pain syndrome because chronic pain alters how their nervous system works.
Central pain syndrome can affect anyone with damage to their central nervous system, which includes your brain and spinal cord. It can also happen to anyone who experiences chronic pain. It’s also much more likely to happen to people with certain neurological (brain or nervous system) issues. The following percentages are estimates of people with the listed condition who also have CPS:
Central pain syndrome affects as many as 7 million people around the world.
Central pain syndrome involves changes to the way you feel pain, like:
People with CPS often describe pain in similar ways. The most common descriptions include:
Living with chronic pain can take a toll on a person’s mental health and well-being. As a result, people with pain-related conditions like CPS often also have the following:
Central pain syndrome happens for two main reasons: Injury or damage to your brain or spinal cord or because of chronic pain.
Several conditions can damage your brain and spinal cord, but some are more common than others, including:
Any condition that causes chronic pain can also cause central pain syndrome. Because of that, experts have connected CPS with several chronic pain-linked conditions. Some of those include:
Experts have also uncovered evidence that genetics play a role in developing central pain syndrome and conditions linked to it. That connection is especially clear in first-degree relatives, which are your biological parents, siblings or children. People with a first-degree relative with central pain syndrome have a risk of developing pain problems that are eight times higher than people without a family history. But experts have yet to pinpoint specific genetic mutations that explain this increased risk.
One way to think about pain and its effects is to imagine your body as a complex building. Your nervous system’s ability to feel and process pain throughout your body acts very much like the fire alarm system of the building. When your nervous system picks up signs of damage and injury to your body, it sets off the alarm to let you know there’s a problem.
There are two kinds of pain:
There are nerve endings that are sensitive to different causes of pain throughout your body, much like a fire alarm system’s network of smoke detectors or heat sensors. Damage to nearby cells releases certain chemical warning markers into your blood. Your nerve endings notice those chemicals and send high-priority signals to your brain (via your spinal cord). Your brain interprets them as pain and then sends signals to other parts of your brain to act to protect you, like moving away or stopping whatever is causing the pain. For example, when your hand touches a surface that’s hot enough to burn your hand slightly, nerve endings detect those markers and send signals to your brain, which prompts you to move your hand away from the heat.
Central pain syndrome is like a malfunction in the fire alarm system for the building that is your body. Those malfunctions can happen in different ways.
Changes from injuries or damage
Central pain syndrome from injuries or damage happens differently depending on location:
Changes from chronic pain
Your body treats pain signals as a high priority because they’re supposed to protect you from more damage. But when you have chronic pain, your nervous system must handle these high-priority signals more often and for longer periods than it would under normal circumstances.
Over time, your nervous system and brain start to process pain signals. That usually involves your nervous system becoming too sensitive to pain or becoming so sensitive it interprets non-pain signals as painful.
Because pain also causes activation of other systems in your body, especially ones involving hormones, your immune system and your body’s self-repair processes, chronic pain and CPS can also disrupt how those systems work. That can affect your endocrine system, leading to adrenal disorders.
Diagnosing central pain syndrome (CPS) is often tricky because pain feels different from person to person. Because of that, a healthcare provider will need to gather a detailed history of your pain, including the following information:
Depending on the circumstances, providers may also run diagnostic, imaging or lab tests. Lab tests are most likely to check if you have an undiagnosed inflammatory or immune disorder that could cause the kind of pain you have. Your healthcare provider is the best person to explain what kind of tests they recommend for your specific circumstances and case and why they recommend those.
Diagnostic and imaging tests can sometimes help pinpoint central pain syndrome due to a brain or spinal cord injury. The tests that often help with this include:
There’s also a variant of MRI that can help in cases like this. That variant, known as “functional MRI (fMRI),” can detect activity in your brain, including when different areas of your brain are or aren’t working together.
Currently, there’s no cure for central pain syndrome, but there are many treatment options available. When central pain syndrome happens because of an underlying condition, treating or curing the underlying condition can help CPS.
Most treatment plans start with various types of pain medications. Those range from nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, to controlled substance pain relievers, such as opioid drugs.
But many of these more-common painkillers, even the stronger opioid medications, often aren’t effective in treating CPS. If those don’t work, providers may try one or more of the following medications (either separately or in combinations):
Some experimental treatments include drugs best known for recreational use, but that are now the focus of ongoing research. These may one day become part of standard treatment for CPS.
A wide range of nonmedication methods, some approved and some experimental, might help with CPS. A few examples include:
Because mental health conditions are so common with pain conditions, experts often build mental healthcare options into treatment plans for central pain syndrome. For example, cognitive behavioral therapy (CBT) can help you learn and develop coping techniques for mental health concerns that often happen alongside CPS.
Physical therapy can help you adapt to your condition. It can also help improve your muscle strength, flexibility and coordination.
The complications and side effects that are possible with treatments for central pain syndrome vary greatly, depending on which treatments you receive. Your healthcare provider is the best person to tell you the specifics of what you can expect.
CPS isn’t a condition you can diagnose on your own, so you shouldn’t attempt to treat it by yourself. If you think you might have this condition, you should see a healthcare provider. They can diagnose your condition and guide you to treatments.
The time it takes to feel better or recover from treatments related to CPS varies greatly. Ask your healthcare provider about the timeline you can expect for treatment and recovery. They can best tell you what to expect based on your specific circumstances.
CPS happens unpredictably based on several factors, most of which you can’t control. Because of that, this condition isn’t preventable.
When central pain syndrome happens because of injuries or damage to your brain or spinal cord, there’s very little you can do to reduce your risk of developing it. Wearing safety equipment and gear to avoid head and spinal cord injuries can reduce your risk slightly by preventing injuries that could lead to CPS.
The best way to reduce your risk of developing CPS related to chronic pain is to get treatment for pain-related conditions sooner rather than later. It’s also important to follow your healthcare provider’s guidance in treating those conditions. Doing both reduces the risk of developing chronic pain that could lead to CPS in the future.
Central pain syndrome can have major effects on your quality of life, especially your ability to do what you enjoy.
The outlook for this condition depends strongly on if it has any underlying causes. In cases where there’s an underlying cause that’s curable, it’s more likely that you can treat or reverse some of the effects of this condition.
In cases where the underlying cause isn’t curable, the best approach is to treat the symptoms of CPS and prevent them from getting worse.
Early diagnosis and treatment are also important. It’s also important to make sure you see mental health providers as needed and recommended. That’s because people with this condition have a higher risk of developing anxiety and depression, as well as a higher risk of dying by suicide.
Central pain syndrome is usually a permanent condition. In some cases, the effects are reversible depending on why it happens and how soon you receive treatment.
If you have central pain syndrome, you should follow your healthcare provider’s guidance on how to take care of yourself and treat your condition. The best things you can do include the following:
You should see your healthcare provider as they recommend. They’ll most likely schedule regular appointments to see how you’re doing and adjust treatments as needed. You should also see them if you notice changes in your symptoms, especially changes that happen quickly or disrupt your usual activities and routine.
You should get emergency medical care if your symptoms change or become especially severe in a short period. This is especially true if your CPS symptoms include any stroke symptoms. Your healthcare provider can also tell you any signs or symptoms specific to you that mean you should get emergency medical care.
A note from Cleveland Clinic
Central pain syndrome (CPS) is a serious condition that can have a major impact on your life. It can be a source of stress and pain, keeping you from living your life the way you want. While central pain syndrome has a well-earned reputation for being difficult to treat, researchers are developing promising therapy methods, medications and treatment approaches. As research continues, even more opportunities to treat this condition are likely, offering hope and relief to those with this condition.
Last reviewed by a Cleveland Clinic medical professional on 06/30/2023.
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