Combined Transcranial Direct Current Stimulation and Thermotherapy for Managing Central Post-stroke Pain in a Patient With Severe Paretic Hemiplegia: A Case Report

Central post-stroke pain (CPSP) is one of the sequelae that significantly impacts the quality of life for stroke patients. This case report examines the effects of a combined intervention, which included thermotherapy using warm water and transcranial direct current stimulation (tDCS) in a woman in her 50s who experienced severe left hemiplegia and CPSP following stroke. After thermotherapy aimed at reducing pain, tDCS was applied to the primary motor cortex for two weeks. In addition, robotic therapy targeting shoulder and elbow joint movements was introduced as a form of self-training to complement the intervention. Post-intervention assessments revealed improvements in upper limb motor function and a reduction in pain intensity, as indicated by a decrease in the numerical rating scale scores from a pre-intervention range of 4 to 10 to a post-intervention range of 4.5 to 6. These results suggest that a combined approach centered on tDCS may promote pain management and functional recovery in patients with CPSP.