Post-Stroke Pain, also known as Central Post-Stroke Pain (CPSP), is a complex type of neuropathic pain that can occur after a stroke. It arises when the part of the brain responsible for processing sensation — often the thalamus or sensory pathways — is damaged by the stroke. As a result, the brain misinterprets normal sensory signals, causing pain where there is no ongoing injury.
CPSP typically develops weeks to months after the stroke and can affect areas of the body on the opposite side to where the stroke occurred in the brain.
Typical symptoms include:
Post-stroke pain reflects nervous system overactivity and reorganisation following brain injury — it is not due to weakness, muscle spasm, or joint strain alone. However it is worth noting that other, overlapping pain conditions often accompany stroke, due to changes in how we move, our daily activity and often associated muscle wasting or weakness.
At Wessex Pain Clinic, diagnosis begins with a detailed clinical history and neurological assessment, often in partnership with stroke and rehabilitation specialists.
We review:
This comprehensive evaluation distinguishes CPSP from other post-stroke issues such as muscle spasticity or joint pain.
Our neuro-physiotherapists and rehabilitation partners work to maintain mobility, strength, and function through graded movement programmes tailored to post-stroke recovery.
Our pain psychology partners help patients address the emotional and cognitive challenges of living with pain after stroke, using techniques such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based approaches to build resilience.
Hydrotherapy and gentle exercise can help restore flexibility and confidence in movement.
This consultant-led, multidisciplinary model ensures that post-stroke pain is treated in its full context — neurologically, physically, and emotionally. At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.
We may recommend:
• Neuropathic pain medicines such as amitriptyline, duloxetine, pregabalin, or gabapentin to calm overactive nerve pathways
• Tricyclic or serotonin-noradrenaline reuptake inhibitors (SNRIs) for combined mood and pain benefits
• Anticonvulsants for nerve stabilisation
• Topical lidocaine or capsaicin for localised sensitivity
• Simple analgesics or anti-inflammatories for secondary joint or muscle pain related to immobility
All treatments are closely monitored for tolerability, especially in patients with other medical conditions post-stroke.
In more persistent or severe cases, our consultants may offer image-guided or infusion-based therapies, including:
Our friendly team is on hand to support you every step of the way. Please get in touch at any time.
