Frequency of neuropathic pain and its effects on rehabilitation outcomes, balance function and quality of life among people with traumatic spinal cord injury

Khan, Muhammad Idrees; Arsh, Aatik; Ali, Ikram; Afridi, Aman Khan

doi:10.12669/pjms.38.4.4681

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Our study’s findings that burn patients with NP report worse physical and psychosocial outcomes correlate with those experiencing NP after other traumatic injuries. In patients recovering from traumatic spinal cord injury, NP is associated with worse quality of life, a more tenuous rehabilitation course, and increased risk for worse psychological sequelae 24,25 . Our BMS study found after controlling for covariates, risk factors associated with NP after burn injury included patient characteristics such as sex, reported pain levels, ethnicity, and employment.…”

Section: Discussionmentioning

confidence: 66%

“…In patients recovering from traumatic spinal cord injury, NP is associated with worse quality of life, a more tenuous rehabilitation course, and increased risk for worse psychological sequelae. 24,25 Our BMS study found after controlling for covariates, risk factors associated with NP after burn injury included patient characteristics such as sex, reported pain levels, ethnicity, and employment. These findings are consistent with the current literature, which also identifies substance/tobacco use to be risk factors for NP development.…”

Section: Discussionmentioning

confidence: 88%

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Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Stanton,

Kowalske,

Won

et al. 2023

Annals of Surgery

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Objective: To address the limited understanding of neuropathic pain (NP) among burn survivors by comprehensively examining its prevalence and related factors on a national scale using the Burn Model System (BMS) National Database. Summary Background Data: NP is a common but underexplored complaint among burn survivors, greatly affecting their quality of life and functionality well beyond the initial injury. Existing data on NP and its consequences in burn survivors are limited to select single-institution studies, lacking a comprehensive national perspective. Methods: The BMS National Database was queried to identify burn patients responding to NP-related questions at enrollment, six months, 12 months, two years, and five years post-injury. Descriptive statistics and regression analyses were used to explore associations between demographic/clinical characteristics and self-reported NP at different time points. Results: There were 915 patients included for analysis. At discharge, 66.5% of patients experienced NP in their burn scars. Those with NP had significantly higher PROMIS-29 pain inference, itch, anxiety, depression, and sleep disturbance scores and were less able to partake in social roles. Multiple logistic regression revealed male sex, %TBSA, and moderate-to-severe pain as predictors of NP at six months. At 12 months, %TBSA and moderate-to-severe pain remained significant predictors, while ethnicity and employment status emerged as significant predictors at 24 months. Conclusions: This study highlights the significant prevalence of NP in burn patients and its adverse impacts on their physical, psychological, and social well-being. The findings underscore the necessity of a comprehensive approach to NP treatment, addressing both physical symptoms and psychosocial factors.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 88%

Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Stanton,

Kowalske,

Won

et al. 2023

Annals of Surgery

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Capsaicin 8% Patch for Spinal Cord Injury Focal Neuropathic Pain, a Randomized Controlled Trial

et al. 2022

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Background Neuropathic pain (NP) after spinal cord injury (SCI) exacerbates disability, decreases quality of life (QOL) and is often refractory to available therapies. Patients report willingness to trade potential recovery of strength, bowel, bladder, or sexual function for pain relief. One proposed mechanism causing NP is up-regulation of transient receptor potential vanilloid 1 (TRPV 1) proteins in uninjured C fibers and dorsal root ganglia causing neuronal excitability. Recent studies have found up-regulation of TRPV 1 proteins after SCI. Objective We hypothesize the application of Capsaicin 8% patch (C8P), FDA approved for NP in diabetic peripheral neuropathy and post herpetic neuralgia, will improve pain, function and QOL in persons with SCI. Design/Methods Randomized single-blind crossover design in which 11 persons with SCI and NP refractory to two oral pain medications received C8P or a control low dose Capsaicin 0.025% patch (CON) over two 12-week periods. Pain (VAS, MPI-SCI), quality of life (WHO-QOL), and functional status (SCIM) were measured at 2–4-week intervals. Results There was a main treatment effect of C8P over CON on VAS and MPI-SCI outcomes with pain reduction of 35% and 29% at weeks 2 and 4 respectively. C8P also demonstrated a main treatment effect over CON on the SCIM mobility subscale. WHO-QOL scores did not improve with C8P. Conclusion C8P improves pain and mobility for patients with SCI and refractory NP. Larger studies should be performed to evaluate impact of repeat applications and QOL outcomes.

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The relationship between changes in inflammation and locomotor function in sensory phenotypes of central neuropathic pain after spinal cord injury

Avonts,

Shen,

Wrobel

et al. 2024

PR9

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Introduction: Central neuropathic pain (CNP) commonly develops in patients after spinal cord injury (SCI), causing debilitating symptoms and sensory abnormalities to mechanical and thermal stimuli. The biological variability of pain phenotypes in individuals has limited the number of positive outcomes. Thus, it is necessary to investigate the physiological processes contributing to sensory changes that develop over time. Objective: To investigate the physiological processes contributing to neuropathic pain sensory changes and locomotor impairments with sensory phenotypes that develop over time. Methods: Using the tail flick and von Frey tests, we performed hierarchical clustering to determine the subpopulation of rats that developed thermal and mechanical sensory abnormalities. To measure inflammation as a potential mediator of CNP phenotypes, we used flow cytometry and immunohistochemistry. Finally, to assess the secondary effects on locomotor recovery, up to 8 weeks after injury, we used the CatWalk test to assess multiple parameters of gait. Results: The von Frey test showed a subpopulation of SCI rats that were hyposensitive to mechanical stimuli from 6 to 8 weeks after injury. The tail flick test showed a subpopulation of SCI rats that were hypersensitive to thermal stimuli at 1 week and 3 to 8 weeks after injury. Although there were no differences in inflammatory cells between subpopulations, we did see significant changes in locomotor recovery between rats with and without sensory abnormalities. Conclusion: The myeloid cell population at large is not affected by mechanical or thermal phenotypes of pain in this model; however, locomotor recovery is impaired depending on the pain phenotype present. Further investigation into acute inflammatory cells may be insightful for predicting the development of pain phenotypes.

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Frequency of neuropathic pain and its effects on rehabilitation outcomes, balance function and quality of life among people with traumatic spinal cord injury

Cited by 3 publications

References 21 publications

Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Neuropathic Pain After Burn Injury: A Severe and Common Problem in Recovery

Capsaicin 8% Patch for Spinal Cord Injury Focal Neuropathic Pain, a Randomized Controlled Trial

The relationship between changes in inflammation and locomotor function in sensory phenotypes of central neuropathic pain after spinal cord injury

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