Mental Imagery as a Rehabilitative Therapy for Neuropathic Pain in People With Spinal Cord Injury: A Randomized Controlled Trial

Neurorehabil Neural Repair. 2020 Nov;34(11):1038-1049. doi: 10.1177/1545968320962498. Epub 2020 Oct 10.

Abstract

Background: Pain of neuropathic origin in spinal cord injury (SCI) is unbearable and challenging to treat. Research studies conducted in the past have shown that mental imagery (MI) techniques have a significant impact on the reduction of symptoms of central neuropathic pain in people with SCI.

Objectives: The objective of this study was to evaluate the effect of MI training on pain intensity, neuropathic pain symptoms, and interference of pain with function in SCI.

Methods: A total of 42 SCI participants with central neuropathic pain (duration 6-12 months) were recruited and randomly allocated to MI or control groups. A MI training protocol was administered to MI group and for 30 min/d for 5 days. Outcome measures were assessed at baseline and at the end of 4 weeks.

Results: There was significant reduction in differences of mean [95% CI] scores of numeric rating scale (-2.1 [CI -2.78 to -1.41]; P < .001) between groups. Mean [95% CI] total scores of Neuropathic Pain Symptom Inventory declined in MI group as compared with control group (-4.52 [CI -5.86 to -3.18]; P < .001). Similarly, Brief Pain Inventory interference scale total dropped significantly (P < .001) in MI group. Majority of participants in the MI group (55%) reported improvement in scores of Patients' Global Impression of Change scale as compared with control group where most of the participants (52%) reported no change.

Conclusions: This study shows the effectiveness of the MI protocol developed as a rehabilitative approach in improving central neuropathic pain in SCI. Trial Registration. Clinical Trials Registry-India under Indian Council of Medical Research; CTRI/2018/07/014884. Registered July 16, 2018.

Keywords: guided imagery; mental imagery; neuropathic pain; pain; rehabilitation; spinal cord injury; visual analogue scale.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Imagery, Psychotherapy*
  • Male
  • Neuralgia / etiology
  • Neuralgia / rehabilitation*
  • Spinal Cord Injuries / complications*
  • Treatment Outcome

Associated data

  • CTRI/CTRI/2018/07/014884