Management of pain in individuals with spinal cord injury: Guideline of the German-Speaking Medical Society for Spinal Cord Injury

GMS German Medical Science, 2019 · DOI: 10.3205/000271 · Published: June 17, 2019

Spinal Cord Injury Pain Management Research Methodology & Design

Simple Explanation

This clinical practice guideline addresses the significant problem of pain management following spinal cord injury (SCI). It acknowledges the challenges in classifying and treating SCI-related pain, particularly neuropathic pain, due to limited treatment options and sparse evidence. The guideline emphasizes the need for a standardized and comprehensive approach to pain management in SCI. It recommends therapeutic strategies, both pharmacological and non-pharmacological, for nociceptive and neuropathic pain. It highlights the importance of standardized assessment methods but points out the limitations of current evidence-based therapeutic options, calling for further clinical studies to improve pain management in SCI.

Study Duration

Not specified

Participants

Experts from different disciplines – neurologists, psychologists, pain specialists, a physiatrist, and a physiologist

Evidence Level

S2k guideline

Key Findings

1
The guideline recommends the International Spinal Cord Injury Pain (ISCIP) classification for SCI-related pain.
2
Pharmacological recommendations include pregabalin and gabapentin as first-line therapies for neuropathic pain, with specific dosage and administration guidelines.
3
Non-pharmacological recommendations include physical activity, exercise, and physiotherapy as beneficial for chronic musculoskeletal pain related to SCI.

Research Summary

This clinical practice guideline provides a structured approach to pain management in individuals with spinal cord injury (SCI), addressing challenges in classification, assessment, and therapy. The guideline, based on a consensus process, offers specific recommendations for pharmacological and non-pharmacological treatments, emphasizing the importance of individualized approaches and the need for further research. It aims to improve healthcare for SCI individuals by standardizing pain management and identifying gaps in evidence for future therapeutic developments.

Practical Implications

Standardized Pain Assessment

Promotes consistent and thorough evaluation of pain in SCI patients using validated tools and classification systems.

Personalized Treatment Plans

Encourages individualized therapeutic approaches combining pharmacological and non-pharmacological interventions based on patient-specific needs.

Improved Clinical Practice

Offers a practical resource for healthcare professionals, guiding daily routines and highlighting areas for future research and improved pain management strategies.

Study Limitations

1
Limited evidence base for certain treatments, especially non-pharmacological interventions.
2
Consensus-based guideline, not developed by means of a systematic review of existing evidence.
3
Lack of long-term studies for many therapeutic approaches.

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