Interrelationship of Neurogenic Obesity and Chronic Neuropathic Pain in Persons With Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2021 · DOI: 10.46292/sci20-00062 · Published: January 1, 2021

Spinal Cord Injury Endocrinology Pain Management

Simple Explanation

Chronic pain and obesity frequently occur together, with symptom severity correlating with body mass index (BMI). This relationship is logical for musculoskeletal pain, where increased weight strains the body, and pain reduces exercise. Neurogenic obesity, common after spinal cord injury (SCI), involves muscle atrophy, osteoporosis, and metabolic issues. Adipose tissue releases proinflammatory cytokines, sensitizing pain neurons and potentially worsening neuropathic pain after SCI. Chronic neuropathic pain is common after SCI. Research suggests that neurogenic obesity may be a contributing factor and is worthy of further study.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Higher BMI is associated with greater pain severity in persons with chronic SCI, irrespective of the type of pain.
2
Obesity may be linked to neuropathic pain conditions, as obesity has been reported as a risk factor for the development of postsurgical pain.
3
Overweight individuals with neuropathic pain reported significantly higher overall pain scores and neuropathic pain-specific symptom severity scores compared to normal weight individuals.

Research Summary

A traumatic injury to the spinal cord causes an immediate cascade of inflammatory responses that, among other things, can initiate hypersensitivity within nociceptive pathways leading to chronic neuropathic pain in 50% of those injured. The presence of metabolic syndrome and ongoing, systemic inflammation conferred by neurogenic obesity after an SCI may also contribute to the initiation or exacerbation of neuropathic pain symptoms. Although there is a paucity of literature demonstrating a causal link between obesity and neuropathic pain in SCI, it would appear that this would be a fruitful, if not essential, line of investigation and one in which a majority of persons with chronic SCI would benefit.

Practical Implications

Targeted Interventions

Clarifying the mechanisms between obesity and neuropathic pain may help to guide targeted interventions to prevent negative consequences of SCI.

Future Research

Longitudinal studies are needed to evaluate the direction and strength of relationships, and to uncover the mechanisms responsible for these relationships.

Clinical Practice

Measuring specific components of neurogenic obesity, including assessing body composition metrics, and differentiating neuropathic pain phenotypes will be important for clarifying mechanisms.

Study Limitations

1
Paucity of literature demonstrating a causal link between obesity and neuropathic pain in SCI.
2
Small sample sizes in some studies limit the impact and generalizability of findings.
3
Studies are needed to evaluate the direction and strength of relationships, and to uncover the mechanisms responsible for these relationships.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury