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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.5

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2013007944
pages 159-172

Central Neuropathic Pain in Spinal Cord Injury

Sujin Lee
Department of Physical Medicine and Rehabilitation, University of California, Irvine, Orange, California
Xing Zhao
Department of Physical Medicine and Rehabilitation, University of California, Irvine, CA
Maya Hatch
Reeve-Irvine Research Center, University of California, Irvine, CA
Sophia Chun
Spinal Cord Injury Medicine/ Disease, Long Beach VA Hospital, Long Beach, CA
Eric Y. Chang
Department of Physical Medicine and Rehabilitation, University of California, Irvine, Orange, California

ABSTRACT

Spinal cord injury (SCI) is a devastating medical condition affecting 1.2 million people in the United States. Central neuropathic pain is one of the most common medical complications of SCI. Current treatment options include opioids, antiepileptic agents such as gabapentin, antispastic agents such as baclofen or tizanidine, and tricyclic acid. Other options include complementary, nonpharmacological treatment such as exercise or acupuncture, interventional treatments, and psychological approaches. Although these treatment options exist, central neuropathic pain in patients with SCI is still extremely difficult to treat because of its complexity. To develop and provide more effective treatment options to these patients, proper assessment of and classification tools for central neuropathic pain, as well as a better understanding of the pathophysiology, are needed. A combination of approaches, from standard general pain assessments to medically specific questions unique to SCI pathophysiology, is essential for this population.

A multidisciplinary approach to patient care, in addition with a better understanding of pathophysiology and diagnosis, will lead to improved management and treatment of patients with SCI displaying central neuropathic pain. Here we summarize the most recent classification tools, pathophysiology, and current treatment options for patients with SCI with central neuropathic pain.


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