Kroniske smerter etter ryggmargsskade

Rekand, Tiina; Hagen, Ellen Merete; Grønning, Marit

doi:10.4045/tidsskr.11.0794

Cited by 43 publications

(16 citation statements)

References 64 publications

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“…Neuropathic pain may also develop because of compression of nerve roots after spinal trauma [31, 32]. Clinically, this pain will often be localized above the level of injury [31].…”

Section: Pathophysiologymentioning

confidence: 99%

“…The localization, duration, intensity and characteristics of pain are useful information when assessing the pain [8, 32]. The clinical examination must include a neurological status with a mapping of sensory phenomena in the painful area, indicating the presence of neuropathic pain [32]. It is important to collect data regarding previous surgical and medical treatment [8].…”

Section: Clinical Examinationmentioning

confidence: 99%

“…The analgesic effect of these drugs has been explained by action through multiple pathways [32]. Several studies have reported on the efficacy of gabapentin.…”

Section: Treatmentmentioning

confidence: 99%

“…Opioids are potent drugs and recommended as a medication against intractable pain after SCI [32, 56, 57]. Tramadol has been shown to be effective in the randomized placebo-controlled study on 35 patients with SCI-related neuropathic pain [58].…”

Section: Treatmentmentioning

confidence: 99%

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Management of Neuropathic Pain Associated with Spinal Cord Injury

2015

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Spinal cord injury (SCI) is an injury to the spinal cord that leads to varying degrees of motor and/or sensory deficits and paralysis. Chronic pain of both neuropathic and nociceptive type is common and contributes to reduced quality of life. The aim of the review is to provide current clinical understanding as well as discuss and evaluate efficacy of pharmacological interventions demonstrated in the clinical studies. The review was based on literature search in PubMed and Medline with words “neuropathic pain” and “spinal cord injury”. The review included clinical studies and not experimental data nor case reports. A limited number of randomized and placebo-controlled studies concerning treatment options of neuropathic pain after SCI were identified. Amitriptyline, a tricyclic antidepressant and the antiepileptic drugs, gabapentin and pregabalin, are most studied with demonstrated efficacy, and considered to be the primary choice. Opioids have demonstrated conflicting results in the clinical studies. In addition, administration route used in the studies as well as reported side effects restrict everyday use of opioids as well as ketamine and lidocaine. Topical applications of capsaicin or lidocaine as well as intradermal injections of Botulinum toxin are new treatment modalities that are so far not studied on SCI population and need further studies. Non-pharmacological approaches may have additional effect on neuropathic pain. Management of pain should always be preceded by thorough clinical assessment of the type of pain. Patients need a follow-up to evaluate individual effect of applied measures. However, the applied management does not necessarily achieve satisfactory pain reduction. Further clinical studies are needed to evaluate the effect of both established and novel management options.

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“…Neuropathic pain may also develop because of compression of nerve roots after spinal trauma [31, 32]. Clinically, this pain will often be localized above the level of injury [31].…”

Section: Pathophysiologymentioning

confidence: 99%

Section: Clinical Examinationmentioning

confidence: 99%

“…The analgesic effect of these drugs has been explained by action through multiple pathways [32]. Several studies have reported on the efficacy of gabapentin.…”

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Management of Neuropathic Pain Associated with Spinal Cord Injury

2015

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“…A large body of evidence indicates that the immune mechanisms play a pathogenetic role in pain syndromes [8,12,14]. Studying the involvement of immune factors in the regulation of nociceptive sensitivity in mammals should be focused on cytokines.…”

mentioning

confidence: 99%

Correlation Dependencies between Nociceptive Sensitivity and Cytokine Level in Biological Fluids of Rats after Administration of Lipopolysaccharide

Abramova

Перцов

2014

Bull Exp Biol Med

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Correlation dependencies between nociceptive sensitivity and cytokine level in biological tissues of rats were studied on days 1 and 7 after antigenic stimulation due to intraperitoneal injection of LPS (30 μg/kg). No correlations were found between the nociceptive thresholds and cytokine contents in the dorsal hippocampus and anterior cingulate cortex of animals. Inverse correlations between the tail-flick latency in response to nociceptive stimulation and concentrations of an anti-inflammatory cytokine IL-10 and pro-inflammatory cytokine TNF-α in the peripheral blood of rats were revealed on day 7 after LPS injection. These animals were characterized by the following inverse correlations between the blood level of proinflammatory cytokines and baseline parameters of nociceptive sensitivity: IL-4 and latency of the tail-flick response; and IL-10 and vocalization threshold. The appearance of significant correlations between immune and nociceptive parameters in rats was shown to coincide with pronounced changes in the perceptual and emotional components of nociception in animals during antigenic stimulation. The formation of close interrelations between nociceptive sensitivity and immune processes in this period probably contributes to the systemic response to antigenic stimulation. Our results complement previous data on the relationship between individual immune reactivity and type of nociceptive reactions in mammals.

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