Future Treatment of Neuropathic Pain in Spinal Cord Injury: The Challenges of Nanomedicine, Supplements or Opportunities?

Abstract

Neuropathic pain (NP) is a common chronic condition that severely affects patients with spinal cord injuries (SCI). It impairs the overall quality of life and is considered difficult to treat. Currently, clinical management of NP is often limited to drug therapy, primarily with opioid analgesics that have limited therapeutic efficacy. The persistence and intractability of NP following SCI and the potential health risks associated with opioids necessitate improved treatment approaches. Nanomedicine has gained increasing attention in recent years for its potential to improve therapeutic efficacy while minimizing toxicity by providing sensitive and targeted treatments that overcome the limitations of conventional pain medications. The current perspective begins with a brief discussion of the pathophysiological mechanisms underlying NP and the current pain treatment for SCI. We discuss the most frequently used nanomaterials in pain diagnosis and treatment as well as recent and ongoing efforts to effectively treat pain by proactively mediating pain signals following SCI. Although nanomedicine is a rapidly growing field, its application to NP in SCI is still limited. Therefore, additional work is required to improve the current treatment of NP following SCI.

Feasibility of using remotely delivered Spring Forest Qigong to reduce neuropathic pain in adults with spinal cord injury: a pilot study

“…We are therefore confident that the proposed results are due to Qigong and not due to the placebo. Moreover, neuropathic pain is known to be resistant to pharmacological and non-pharmacological interventions such as surgery, neurostimulation (Forte et al, 2022), and physical and psychological therapy, and therefore the large effect size results seen with Qigong are very encouraging. Furthermore, while we recruited participants living in remote Frontiers in Physiology frontiersin.org 13 areas and/or in financial distress, diversity in terms of race and ethnicity was missing.…”

“…The mechanisms underlying neuropathic pain are not completely understood but are commonly reported as being related to damage to the somatosensory system in the peripheral or central nervous system ( Raja et al, 2020 ; Ghazisaeidi et al, 2023 ). Due to this damage, changes occur at all levels of somatosensory circuitry (i.e., the spinal cord, brainstem, and brain), altering the sensorial communication between the brain and the body, resulting in the development of various degrees of sensory and motor impairment and aberrant pain sensations above, below, or at the level of the lesion ( Chambel, Tavares, and Cruz, 2020 ; Forte et al, 2022 ). Furthermore, changes in brain function may contribute to neuropathic pain ( Hawasli et al, 2018 ; Huynh et al, 2019 ; Black et al, 2021 ).…”

Sistema Nervoso E a Lesão Medular

“…6 Além disso, medicações podem ser prescritas para tratar dor, espasticidade, infecções e outras complicações decorrentes da lesão medular. Entre as medicações utilizadas para tratar complicações decorrentes da lesão medular, destacam-se o baclofeno, utilizado para tratar a espasticidade, 25 a gabapentina, utilizada para tratar a dor neuropática, 26 o oxibato de sódio, utilizado para tratar a fadiga excessiva, 27 o metilfenidato, um estimulante utilizado para tratar a fadiga e melhorar a cognição, 27 antibióticos, utilizados para tratar infecções, principalmente urinária 28 e anticoagulantes, utilizados para prevenir coágulos sanguíneos. 29 Estes tratamentos medicamentosos podem contribuir para melhorar a qualidade de vida dos indivíduos com lesão medular, minimizando as complicações decorrentes da lesão.…”

Integrated Neuroregenerative Techniques for Plasticity of the Injured Spinal Cord

“…In SCI, the nanotechnology approach represents a significant advancement [ 38 ], targeting neuroprotection and regeneration of tissues and networks impaired after SCI. The main benefit of nanotechnology is attributed to its ability to facilitate drug transport and overcome biological barriers to achieve its goals [ 9 , 38 ]. Preclinical studies provide promising results, especially when combination therapies target multiple mechanisms underlying SCI [ 9 ].…”