Chronic neuropathic pain in SCI: evaluation and treatment

Phys Med Rehabil Clin N Am. 2014 Aug;25(3):545-71, viii. doi: 10.1016/j.pmr.2014.04.007.

Abstract

Chronic neuropathic pain develops in approximately 40% of people after a spinal cord injury (SCI) and is notoriously difficult to treat. Because of the frequent presence of more than one pain type and the complex mechanisms and symptoms associated with pain in individuals with SCI, a thorough evaluation is important. This review includes an overview of the most recent guidelines for evaluating and classifying pain, suggestions for standardizing outcome measures for clinical use, and a review of the positive and negative evidence for pharmacologic and nonpharmacologic interventions to consider when treating individuals with SCI and chronic neuropathic pain.

Keywords: Neuropathic pain; Nonpharmacologic treatment; Pain evaluation; Pain management; Pharmacologic treatment.

Publication types

  • Review

MeSH terms

  • Acupuncture Therapy
  • Analgesics, Opioid / therapeutic use
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Cannabinoids / therapeutic use
  • Chronic Pain / diagnosis
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Cognitive Behavioral Therapy
  • Combined Modality Therapy
  • Denervation
  • Humans
  • N-Methylaspartate / antagonists & inhibitors
  • Neuralgia / diagnosis
  • Neuralgia / etiology
  • Neuralgia / therapy*
  • Pain Management / methods*
  • Pain Measurement
  • Physical Therapy Modalities
  • Spinal Cord Injuries / complications*

Substances

  • Analgesics, Opioid
  • Anticonvulsants
  • Antidepressive Agents
  • Cannabinoids
  • N-Methylaspartate