The effect of neuropathic pain treatments on pain interference following spinal cord injury: A systematic review

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2218186 · Published: May 31, 2023

Simple Explanation

This review examines how treatments for neuropathic pain affect daily life activities and emotional well-being in people with spinal cord injuries. The study looks at various treatment strategies and their impact on pain interference, which includes how pain affects mobility, work, mood, relationships, and sleep. The conclusion highlights that some treatments like pregabalin, gabapentin, intrathecal baclofen, transcranial direct current stimulation, and transcutaneous electrical nerve stimulation have shown promise in reducing pain interference.

Study Duration

Not specified

Participants

Individuals with spinal cord injury and neuropathic pain

Evidence Level

Systematic Review

Key Findings

1
Pregabalin and gabapentin were shown to have a beneficial effect on sleep interference.
2
Intrathecal baclofen had an acute beneficial effect on pain interference, improving general activity, moving around, enjoyment of life, ability to work and perform daily tasks, and relationships with other people.
3
Transcranial direct current stimulation (tDCS), especially when combined with visual illusion, can benefit several aspects of pain interference, including general activity and mood.

Research Summary

This systematic review assessed the efficacy of various strategies for treating pain interference in individuals with neuropathic pain following spinal cord injury. Moderate to high quality studies showed that gabapentin, pregabalin, intrathecal baclofen, transcranial direct current stimulation (tDCS), and transcutaneous electrical nerve stimulation (TENS) had beneficial effects on pain interference. The review highlights the need for further research to confirm the efficacy of these interventions and to provide stronger evidence for their use in reducing pain interference.

Practical Implications

Treatment Strategies

Clinicians can consider pregabalin and gabapentin for sleep interference related to neuropathic pain in SCI, but should monitor for potential side effects.

Interdisciplinary Approaches

The findings support the use of interdisciplinary pain programs to improve life interference due to pain in individuals with SCI.

Future Research

More high-quality studies are needed to provide stronger evidence for the efficacy of various interventions on pain interference in SCI patients.

Study Limitations

1
Limited number of studies assessing pain interference as an outcome following treatment for neuropathic pain in individuals with spinal cord injury.
2
Heterogeneity between studies due to the broad definition of pain interference and the use of varying assessment tools.
3
Several studies were limited by study design and/or analysis/reporting of findings, with many lacking a true control group or reporting only within-group effects.

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