The CanPain SCI clinical practice guidelines for rehabilitation management of neuropathic pain after spinal cord injury: 2021 update

Neuropathic pain (NP) presents significant challenges to those living with spinal cord injury (SCI), with negative effects on function participation, (e.g., mood, sleep), and quality of life. The current document presents updates to the CanPainSCI CPG based on additional relevant literature that has been published since the first iteration of the guidelines. The ongoing goals of these CPG are to (1) provide practical and actionable guidelines with a strong rating on the AGREE-II scale, (2) support standardized care in the rehabilitation management of NP after SCI, and (3) identify opportunities for further research in this area.

• 1
  The panel agreed on three new screening and diagnosis recommendations, and eight new treatment recommendations. No new model of care recommendations were proposed as no relevant articles were identified.
• 2
  The WG agreed that although the overall evidence base remains weak, it is unacceptable for those with NP after SCI, and for clinicians, to have no guidance on management.
• 3
  The CanPainSCI panel made the decision to restructure the classification of treatment recommendations from first to fourth line to the current “first-line”, “B”, “C”, and “D” system, to account for the inherent challenges of working with a limited evidence base.