Pain in Patients with Spinal Cord Injury: A Review

Miguel, Marcia de; Kraychete, Durval Campos

doi:10.1590/s0034-70942009000300011

Cited by 25 publications

(14 citation statements)

References 18 publications

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“…Our study revealed that 70% of neuropathic pain began within the first 6 months of injury, as it was in the review of Miguel and Kraychete. 17 Siddall et al 14 reported that SCI patients with neuropathic pain at or below the level of the injury, 60% and 48%, respectively; described pain as severe or excruciating. Demirel et al 18 reported that pain (all type of pain) was more intense in the evening.…”

Section: Discussionmentioning

confidence: 99%

The clinical characteristics of neuropathic pain in patients with spinal cord injury

Çelik¹,

Erhan²,

Lakse

2012

Spinal Cord

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Objectives: The aim of the study was to evaluate the characteristics of neuropathic pain and observe intensity alterations in pain with regard to time during the day in spinal cord injury (SCI) patients. Methods: A total of 50 SCI patients (M/F, 40/10; mean age, 35 ± 12 years) with at-level and below-level neuropathic pain were included in the study. All patients were examined and classified according to the ASIA/ISCoS 2002 International Neurologic Examination and Classification Standards. The history, duration, localization and characteristics of the pain were recorded. Neuropathic pain of patients was evaluated with the McGill-Melzack Pain Questionnaire and LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) Pain Scale. Visual analog scale (VAS) was used to measure the severity of pain four times during the day. Quality of life was analyzed with Short Form 36. Results: Out of 50 patients, 10 were tetraplegic and 40 were paraplegic. In all, 28 patients had motor and sensory complete injuries (AIS A), whereas 22 patients had sensory incomplete (AIS B, C and D) injuries. The most frequently used words to describe neuropathic pain were throbbing, tiring, hot and tingling. Pain intensity was significantly higher in the night than in the evening, noon and morning (Po0.05) (VAS morning: 5.16 ± 2.42, VAS noon: 5.24 ± 2.52, VAS evening: 5.80 ± 2.46 and VAS night: 6.38 ± 2.19). Conclusion: Neuropathic pain is a serious complaint in SCI patients and affects their quality of life. Neuropathic pain intensity was higher in the night hours than other times of day. This situation reinforces the need for a continued research and education on neuropathic pain in SCI.

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Section: Discussionmentioning

confidence: 99%

The clinical characteristics of neuropathic pain in patients with spinal cord injury

Çelik¹,

Erhan²,

Lakse

2012

Spinal Cord

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“…Neuropathic pain can be manifested in some SCI patients as a painful sensation evoked by a non-noxious stimulus (tactile allodynia) or exaggerated pain sensations to mild painful stimuli (hyperalgesia). Retrospective clinical studies have shown that 65% of SCI patients suffer from pain that interferences with activities of their daily lives, and 60% of those patients use medications for pain management [9,32]. Unfortunately, current pain medications are only partially effective and associated with unwanted side effects.…”

Section: Introductionmentioning

confidence: 99%

Calcium channel alpha-2-delta-1 protein upregulation in dorsal spinal cord mediates spinal cord injury-induced neuropathic pain states

Boroujerdi

Zeng

Sharp

et al. 2011

Pain

127

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Spinal cord injury (SCI) commonly results in the development of neuropathic pain, which can dramatically impair the quality of life for SCI patients. SCI induced neuropathic pain can be manifested as both tactile allodynia (a painful sensation to a non-noxious stimulus) and or hyperalgesia (an enhanced sensation to a painful stimulus). The mechanisms underlying these pain states are poorly understood. Clinical studies have shown that gabapentin, a drug that binds to the voltage gated calcium channel alpha-2-delta-1 subunit (Cavα2δ-1) proteins is effective in the management of SCI induced neuropathic pain. Accordingly, we hypothesized that tactile allodynia post SCI is mediated by an upregulation of Cavα2δ-1 in dorsal spinal cord (DSC). To test this hypothesis, we examined if SCI-induced dysregulation of spinal Cavα2δ-1 plays a contributory role in below-level allodynia development in a rat spinal T9 contusion injury model. We found that Cavα2δ-1 expression levels were significantly increased in L4-6 dorsal, but not ventral, spinal cord of SCI rats that correlated with tactile allodynia development in the hindpaw plantar surface. Furthermore, both intrathecal gabapentin treatment and blocking SCI induced Cavα2δ-1 protein upregulation by intrathecal Cavα2δ-1 antisense oligodeoxynucleotides could reverse tactile allodynia in SCI rats. These findings support that SCI induced Cavα2δ-1 upregulation in spinal dorsal horn is a key component in mediating below-level neuropathic pain development and selectively targeting this pathway may provide effective pain relief for SCI patients.

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“…Furthermore, SCI can cause many long-term complications, such as chronic pain, spasticity, contractures, bowel and bladder dysfunction, bedsores, etc. Pain is one of the most important complications of spinal cord injury (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Shoulder Pain in Spinal Cord Injury Patients Referring to the Brain and Spinal Cord Injury Research Center of Tehran University of Medical Sciences

et al. 2019

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Background: Spinal cord injury (SCI) is a catastrophic event that influences all aspects of the life of the patients and their families. It may have many acute or chronic complications. One of the most common complications is shoulder pain, which particularly occurs in wheelchair users. Objectives: This study aimed to estimate the prevalence of shoulder pain in paraplegic spinal cord injury patients who were referred to our clinic. Methods: We included 70 spinal cord injury patients in our study according to inclusion criteria. Demographic data and SCI-related factors were recorded. The disabilities of the arm, shoulder, and hand (DASH) questionnaire was used to assess shoulder pain in our patients. Results: Mean score of pain was 51 in cervical, 23 in thoracic and 12 in lumbar spinal cord injury according to the DASH questionnaire. The pain was more prevalent and severe in the cervical group. Conclusions: According to our study, it seems that shoulder pain has a relatively high prevalence and is more severe in cervical quadriplegic SCI patients that may be due to muscle imbalance around the shoulder. Therefore, this problem should be noted in the course of managing these patients.

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Pain in Patients with Spinal Cord Injury: A Review

Cited by 25 publications

References 18 publications

The clinical characteristics of neuropathic pain in patients with spinal cord injury

The clinical characteristics of neuropathic pain in patients with spinal cord injury

Calcium channel alpha-2-delta-1 protein upregulation in dorsal spinal cord mediates spinal cord injury-induced neuropathic pain states

Prevalence of Shoulder Pain in Spinal Cord Injury Patients Referring to the Brain and Spinal Cord Injury Research Center of Tehran University of Medical Sciences

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