After suffering a stroke and making a full recovery, a man who had experienced chronic lower back pain for over ten years discovered his pain had completely disappeared. This unique case could potentially lead to ideas for future research and clinical treatment in the field of neuromodulation and brain stimulation.
By Julie Colthorpe
Although extremely rare and unpredictable, a thalamic stroke, which involves the areas that are involved in chronic pain signalling, can potentially lead to the disappearance of an existing chronic pain condition. In a unique case report from the Scandinavian Journal of Pain, the authors present the case of a 66-year old man with a ten-year history of chronic lower back pain (CLBP).
In 2012, the man was referred to the researchers’ pain clinic in Canada. Whilst at the clinic, he was offered radiofrequency (RF) ablation treatment. RF is a procedure that uses an electric current to heat up small areas of nerve tissue which decreases pain signals from that specific area.
Prior to his referral to the clinic, the man’s pain was being managed by a combination of medications including opioids. In addition to his lower back pain, the patient suffered from obesity and several disorders including hypertension, sleep apnea, diabetes Type 2 and mild depression.
Early signs of dementia?
Over the next four years, the patient underwent seven RF sittings and was due for another sitting in early 2016. However, at the start of 2016, the man’s wife noticed her husband was showing odd cognitive and behavioural changes. He became forgetful, failed to remember how to put on his pressure mask for his sleep apnea and started searching for his deceased brother at home.
Suspecting early dementia or vasculitis (inflammation of the blood vessels), the man was taken to the hospital. Tests including a CT scan revealed that the patient had suffered an acute thalamic stroke.
Back pain vanished
Over the next two weeks the man was treated and evaluated at the stroke prevention clinic. He made a complete recovery in his cognitive and behavioural functions, as well as in his memory. Furthermore, his lower back pain completely disappeared. He no longer had to take his pain medications or his daily opioids, which he had been taking for over ten years. In April 2016, more than eighteen months after his stroke, during his examination, similar neurological findings were observed to the findings two months after his stroke.
No more medication
Since the sudden disappearance of CLBP, the man has not felt the need to take to repeat his RF procedure and leads a life with only minimal pain without the need for pain medication or opioids.
The authors conclude that while a stroke can severely affect a person’s health, they find it intriguing that a stroke can potentially limit pain and disability. They recommend that future research and treatments should take into account the potential for neuroplasticity demonstrated in this case study.
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