Rule reminder
Register awareness: 'tale...che' and 'talmente...che' are preferred in formal/literary contexts. 'Così...che' is neutral and versatile. 'Così tanto/tanto...che' is common in spoken Italian. 'Al punto che/da' marks a high degree in both formal and informal registers. 'Tanto + fronted verb + che' is literary/emphatic.
[Registro letterario] "Tanto era il dolore _____ non riusciva a pronunciare parola."