Pregabalin 150 to 600 mg/day was effective in relieving central neuropathic pain, improving sleep, anxiety, and overall patient status in patients with spinal cord injury.

Pain continues to be a signi®cant management problem in people with spinal cord injuries. Despite this there is little consensus regarding the nature, terminology and de®nitions of the various types of pain that occur following spinal cord injury. This has led to large variations in the reported incidence and prevalence of pain following spinal cord injury. Treatment studies have been hampered by inconsistent and inaccurate identi®cation of pain types. We believe that both research and management would bene®t from an agreed upon classi®cation system which accurately and reliably identi®es the types of pain that occur following spinal cord injury. We have reviewed the literature on the classi®cation of pain following spinal cord injury and have developed a classi®cation system which adopts the strengths of previous systems and attempts to avoid the weaknesses inherent in others. Our proposed classi®cation system of pain following spinal cord injury includes four major divisions: musculoskeletal, visceral, neuropathic and other types of pain. We have divided neuropathic pain on the basis of region into two subdivisions: neuropathic at level and neuropathic below level pain. We have further divided neuropathic at level pain into two categories: radicular and central, to indicate the presumed site of the lesion responsible for pain generation. We believe that our proposed classi®cation system is comprehensive, simple and readily applicable in the clinical and research situation. It is our hope that this proposed classi®cation will contribute to the eventual development of a universal system for the classi®cation of pain following spinal cord injury.

Study design: Clinical practice guidelines. Objectives: To develop the first Canadian clinical practice guidelines for treatment of neuropathic pain in people with spinal cord injury (SCI). Setting: The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. Methods: The CanPainSCI Working Group reviewed the evidence for different treatment options and achieved consensus. The Working Group then developed clinical considerations for each recommendation. Recommendations for research are also included. Results: Twelve recommendations were developed for the management of neuropathic pain after SCI. The recommendations address both pharmacologic and nonpharmacologic treatment modalities. Conclusions: An expert Working Group developed recommendations for the treatment of neuropathic pain after SCI that should be used to inform practice.