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Thread: How does pain happen w/o spinal cord ?

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    Senior Member tarheelandy's Avatar
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    How does pain happen w/o spinal cord ?

    Okay, I just don't get why we have nerve pain (mine, the burnning butt like many others) when the spinal column is not active? So, since we know that the brain must be notified by the nerves down below that something is wrong, how does the message get to the brain from the butt?

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    Senior Member alan's Avatar
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    My guess is that the portion of the cord above the injury expects to get messages from the portion below the cord. When it doesn't,in some people, the portion above makes up it's own messages, and they're interpreted as pains. Why they keep getting worse,
    I don't know.
    Alan

    Proofread carefully to see if you any words out.

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    Senior Member tarheelandy's Avatar
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    Alan ,

    The problem I have with that is that my pain is only present when I am sitting on my butt. When I am laying down on my stomach or side it subides. So, there is something that is communicating with my brain when I am sitting. There must be a definite signal there?

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    Senior Member alan's Avatar
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    Quote Originally Posted by tarheelandy View Post
    Alan ,

    The problem I have with that is that my pain is only present when I am sitting on my butt. When I am laying down on my stomach or side it subides. So, there is something that is communicating with my brain when I am sitting. There must be a definite signal there?

    That's possible, I suppose.

    My pains are always present, regardless of position.
    Alan

    Proofread carefully to see if you any words out.

  5. #5
    tarheellady - that is such a great question. As I read your post I am having big time burning from sitting and have complete cutaneous lack of sensation where I am sitting. Maybe this is the million dollar question. I am sure Dejerine can offer an explanation for this. There is clearly afferent information telling the remaining spinal cord and brain, 'hey, I am sitting' but I don't know how that information is being transmitted. I only know I have it bad. Sorry you have it. Dejerine?

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    Senior Member Cjt8's Avatar
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    Quote Originally Posted by tarheelandy View Post
    Alan ,

    The problem I have with that is that my pain is only present when I am sitting on my butt. When I am laying down on my stomach or side it subides. So, there is something that is communicating with my brain when I am sitting. There must be a definite signal there?
    Bingo..... It's like looking no reading in a mirror mater of fact writing this is making my ass and leg hurt worse.
    How about this? Do different cars make your pain worse or better?
    Working out?
    Beer?

  7. #7
    Arndog,

    That is the 64 dollar question. I don't know why.

    There are two theories which get a lot of play

    GD Shott belives that there is some sensation when you are sitting on your behind by virtue of the fact that autonomics, which bypass the cord and most likely travel with the blook vessels register a message, which like other messages in central pain, gets read as pain, usually burning. Lately, there has been some debate whether these nerves that go with blood vessels are actually autonomics.

    A second idea focuses on what is in the brain itself. Expecting certain messages from the peripherae and failing to get them, it generates sufficient query to result in a pain message.

    When speaking of this kind of pain it is helpful to distinguish between the two types of dysesthetic burning, spontaneous and evoked.

    Spontaneous pain is present more or less constantly, on its own. It is thought possible generated by the action potentials which are due to the kinetic energy of heat. Neurons are not steady state. The voltage polarization within the neuron is constantly rising and falling, getting near the potential sufficient to generate an action potential and then falling down, over and over.
    Because the ion channels are more sensitized, these normal voltage fluctuations reach the necessary point to fire a pain signal, and do so regularly.

    Neuroinflammatory chemicals cause acidification at synapses and axons. Acidification is what one is feeling, presumably,, when they feel pain. This acid likely comes from fatty acids. Kenneth Hargreaves has found in the peripheral nervous system that pain comes from oxidized fatty acids. The balance between linolenic and linoleic acids (fatty acids) is altered, and the oxidation of the fatty acids results in an acid environment, which is directly a cause of hypersensitization of pain nerves. Hargreaves is unwilling to speculate whether the same process goes on in central pain. However, study of other acidifying agents has shown that acidification by leukotrienes ascends in the synapses until it reaches the brain. A related idea is the realization that when acidity is present, there is sufficient power to generate action potentials of pain when there is NO stimulus. i.e. H ions morph the ion channels sufficient to cause ions to flow and generate an action potential

    Evoked pain refers to heightened spontaneous pain, and occasionally to pains other than dysesthetic burning. Certain people with lancinating pain have found that certain postures will make the lightning jolts more common. For the most part, evoked or elicited pain requres a STIMULUS, which hypersensitizes the synapses to cause heightened pain. The most common reported stimulus is blast of cold air from air conditioner directly on the skin. Humidity, temperature change, barometic pressure change have also been reported by Central Pain subjects as being evoking factors. Hot weather makes dysesthetic burning more likely, both spontaneous and evoked. Rubbing the skin can evoke heightened pain, which may remain for hours as hypersensitivity. Motion or loading of the muscles can result in what is called kinesthetic dysesthesia, which is usually short lived. The isometric dysesthesia in muscles may be noticed when awaking after the muscles have been at rest, and tends to stay longer than kinesthetic dysesthesia, but this is variable. Some people have really terrible muscle pain so that they are effetively paralyzed. Others havs something like this, but just struggle on. These pains are more typical of incomplete quadriparesis, or paraparesis. There has been noted a not statistically significant correlation of muscle pains in those with central cord syndrome.

    Perhaps the autonomics act to regulate body head to some degree in cord injured. There may also be remnants of function in the muscle spindle system, called the fusofugal apparatus.

    There is also the theory that the brain requires input for the cells to live and when they no longer live, the cells they fed impulses to die, or are injured, and this may lead to truly central generated central pain.


    Careful questioning of the bizarre nature of dysesthetic burning will reveal that it is really a mix of sensations, burning being the most dominant. Paradoxically, there is also an element of what might be called "cold", others have called it "metallic cold". Obviously the thermal tracts are messed up.

    It is still there for some genius to explain Boivie's Paradox. One must lose some sensation to be a candidate for even greater sensation of pain. Dejerine, Egger etc. said any loss of the superficial sensibilities (touch temperature etc) can result in central pain, called by them "thalamic pain". Today thalamic pain is reserved for central pain due to strokes in or near the thalamus. At one time all central pain was called thalamic pain.
    Last edited by dejerine; 08-07-2011 at 04:36 PM.

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    Moderator jody's Avatar
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    Most of my brother in laws cord was gone from the upper abs down. after about eight years he developed some kind of pain syndrome, all I can think of is rls or(RSD)
    but that isnt quite right I dont think. He was using the date rape drug and methadone. it helped some, but he eventually succumbed with the combination. that was about four years ago so maybe there are better ways to help that.

    I have not nearly the injuries but still the burning butt and the sandpaper up the butt feeling. that thankfully doesnt last long, but is intense. about unbearable.
    Last edited by jody; 08-07-2011 at 10:07 PM.

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    Senior Member tarheelandy's Avatar
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    Dejerine,

    Wow, that is way over my head! I am sorry for those of you that have the pain all of the time... mine is definitely stimulated by pressure. Doesn't matter what I sit on or what temp it is. I do know that there is no pain without the brain. I'm more inclined to think there is some kind of peripheral pain nerves going up the body. Who knows? I guess it doesn't really matter but one likes to think there is some kind of connection, even if it doesn't lead to feeling or moving.

  10. #10
    tarheel,

    Sorry the talk must be technical. Arndog is physician so he will know the terms. If you want to learn more, David's site, painonline.org has an educational discussion of these matters. Always consult your own physician for specific questions.

    The important thing to ponder is which of your pains are present all the time (ie spontaneous pain), and which require some sort of stimulus, such as pressure, to bring them out or make them worse. This latter is evoked pain. If either the spontaneous or evoked pain feels like a burn, an unusual burn which is hard to describe, that would likely be dysesthetic pain. The second most common central pain is lancinating, also called lightning or electric jolt pain by many. Muscle pains similar to a burning cramp are also common. There are others. In addition, you may have one or several ordinary pains, usually musculoskeletal.

    If you take medication, make a list of your types of pain. Then, figure out WHICH of the pains the meds are helping, or are not helping. You can then discuss this with your doctor. The ordinary pains should respond to conventional pain meds, such as opiates. The dysesthesia may be another matter. Sometimes changing your environment is as much help as anything, ie avoiding the touch or temperature change things etc. which bring out your pain. In really severe CP it is not unusual to be unable to tolerate clothing or the touch of bedsheets without sedation or other kind of relief..
    Last edited by dejerine; 08-07-2011 at 04:46 PM.

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