Chronic neuropathic pain of spinal cord injury: What is the effectiveness of psychocomportemental management?

Gault, D.; Morel-Fatio, Michel; Albert, T.; Fattal, Charles

doi:10.1016/j.rehab.2008.12.007

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…Sometimes pain and depression create a vicious cycle in which pain worsens symptoms of depression, and then the resulting depression worsens feelings of pain. 39 However, this reason cannot explain the effect lasting 1 and a half months after stopping medication. Figure 6 Four patients in Group B (B10, B17, B18 and B19) had obvious reduction of VASs at 6 weeks and 6 months.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of lithium carbonate treatment of chronic spinal cord injuries: a double-blind, randomized, placebo-controlled clinical trial

Yang

et al. 2011

Spinal Cord

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Study design: Lithium has attracted much attention as a neuroregenerative agent for spinal cord injury in animal models. We hypothesized that the lithium can be beneficial to patients with spinal cord injury. The safety and pharmacokinetics of lithium has been studied in our earlier phase I clinical trial, indicating its safety. This is a phase II clinical trial to evaluate its efficacy on chronic spinal cord injury patients. Objectives: The aim of this study was to investigate the efficacy of lithium on chronic spinal cord injury patients. Setting: A major spinal cord injury rehabilitation center in Beijing, China. Methods: Randomized, double-blind, placebo-controlled 6-week parallel treatment arms with lithium carbonate and with placebo. A total of 40 chronic spinal cord injury subjects were recruited. Oral lithium carbonate was titrated or placebo was simulated to maintain the serum lithium level of 0.6-1.2 mmol l À1 for 6 weeks, followed by a 6-month follow-up. The functional outcomes and the neurological classifications, as well as the safety parameters, adverse events and pharmacokinetic data were carefully collected and monitored. Results: No significant changes in the functional outcomes and the neurological classifications were found. The only significant differences were in the pain assessments using visual analog scale comparing the lithium and the placebo group. No severe adverse event was documented in the study. Conclusion: The lithium treatment did not change the neurological outcomes of patients with chronic spinal cord injury. It is worth to investigate whether lithium is effective in the treatment of neuropathic pain in chronic spinal cord injury. Sponsorship: China Spinal Cord Injury Network Company Limited.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of lithium carbonate treatment of chronic spinal cord injuries: a double-blind, randomized, placebo-controlled clinical trial

Yang

et al. 2011

Spinal Cord

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“…CBT includes a range of behavioral and cognitive strategies such as relaxation training, biofeedback, operant strategies to reinforce adaptive behaviors, hypnosis, and cognitive coping skills. CBT seems more effective for improving coping and for reducing interference with everyday function, mood, and sleep than for reducing pain severity in those with SCI [41,42].…”

Section: At-level and Below-level Spinal Cord Injury Painmentioning

confidence: 99%

Management of Pain After Spinal Cord Injury

Bryce

Gomez

2015

Curr Phys Med Rehabil Rep

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Chronic pain affects most people with spinal cord injury (SCI). It often impedes performance of activities of daily living and negatively impacts quality of life. Pain after SCI can be classified into subtypes through use of the International SCI Pain Classification with key attributes of the pain necessary for effective monitoring and treatment collected within the International SCI Pain Basic Data Set. Many nociceptive causes of pain seen after SCI are potentially treatable and preventable through the implementation of strategies for preventing overuse injuries. Neuropathic pain, in contrast, has been historically difficult to treat. Options for the treatment of neuropathic pain types which have demonstrated some effectiveness include various adjuvant pharmacological agents, neuromodulatory techniques, and psychological approaches.

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“…The purpose of behavioral therapies appears more to reduce psychological symptoms associated with neuropathic pain, which in turn assists individuals with SCI in managing and coping with their pain. 32 Behavioral management to reduce neuropathic pain after SCI has not been supported by the scientific evidence. Further RCTs are needed to determine the benefits associated with CBT and the subsequent effects of decreased psychological strain on the neuropathic pain experience in patients with an SCI.…”

Section: Behavioral Managementmentioning

confidence: 99%

Neuropathic Pain Post Spinal Cord Injury Part 1: Systematic Review of Physical and Behavioral Treatment

Mehta

Orenczuk

McIntyre

et al. 2013

Topics in Spinal Cord Injury Rehabilitation

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Background: Neuropathic pain has various physiologic and psychosocial aspects. Hence, there is a growing use of adjunct nonpharmacological therapy with traditional pharmacotherapy to reduce neuropathic pain post spinal cord injury (SCI). Objective: The purpose of this study was to conduct a systematic review of published research on nonpharmacological treatment of neuropathic pain after SCI. Methods: MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched for articles addressing nonpharmacological treatment of pain post SCI. Articles were restricted to the English language. Article selection was conducted by 2 independent reviewers with the following inclusion criteria: the subjects participated in a treatment or intervention for neuropathic pain; at least 50% of the subjects had an SCI; at least 3 subjects had an SCI; and a definable intervention was being studied. Data extracted included study design, study type, subject demographics, inclusion and exclusion criteria, sample size, outcome measures, and study results. Randomized controlled trials (RCTs) were assessed for quality using the Physiotherapy Evidence Database (PEDro) assessment scale. Levels of evidence were assigned to each intervention using a modified Sackett scale. Results: The 16 articles selected for this review fell into 1 of 2 categories of nonpharmacological management of pain after SCI: physical and behavioral treatments. The pooled sample size of all studies included 433 participants. Of the 16 studies included, 7 were level 1, 3 were level 2, and 6 were level 4 studies. Conclusions: Physical interventions demonstrated the strongest evidence based on quality of studies and numbers of RCTs in the nonpharmacological treatment of post-SCI pain. Of these interventions, transcranial electrical stimulation had the strongest evidence of reducing pain. Despite a growing body of literature, there is still a significant lack of research on the use of nonpharmacological therapies for SCI pain.

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Chronic neuropathic pain of spinal cord injury: What is the effectiveness of psychocomportemental management?

Cited by 9 publications

References 4 publications

Efficacy and safety of lithium carbonate treatment of chronic spinal cord injuries: a double-blind, randomized, placebo-controlled clinical trial

Efficacy and safety of lithium carbonate treatment of chronic spinal cord injuries: a double-blind, randomized, placebo-controlled clinical trial

Management of Pain After Spinal Cord Injury

Neuropathic Pain Post Spinal Cord Injury Part 1: Systematic Review of Physical and Behavioral Treatment

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