Treatments perceived to be helpful for neuropathic pain after traumatic spinal cord injury: A multicenter cross-sectional survey study

• Published in: The journal of spinal cord medicine Vol. ahead-of-print; no. ahead-of-print; pp. 1 - 10
• Main Authors: Bryce, Thomas N., Tsai, Chung-Ying, Delgado, Andrew D., Mulroy, Sara J., Welch, Abigail, Cardenas, Diana D., Taylor, Heather B., Felix, Elizabeth R.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.05.2024
• Subjects: Adult; Aged; Analgesics, Opioid - therapeutic use; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Neuralgia - drug therapy; Neuralgia - etiology; Neuralgia - therapy; Neuropathic pain; Non-pharmacological treatment; Opioids; Pharmacological treatment; Spinal Cord Injuries - complications; Spinal cord injury; Pharmacological treatment; Non-pharmacological treatment; Spinal cord injury; Opioids; Neuropathic pain
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1080/10790268.2022.2108665

Cross-sectional survey. To evaluate the perceived helpfulness of pharmacological and non-pharmacological interventions and their combinations for neuropathic pain (NeuP) and subcategories of NeuP after spinal cord injury (SCI). Six Spinal Cord Injury Model System Centers. Three hundred ninety one individuals at least one year post traumatic SCI were enrolled. A telephone survey was conducted to determine the pharmacologic and non-pharmacologic treatments used in the last 12 months for each participant's three worst pains, whether these treatments were "helpful", and if currently used, each treatments' effectiveness. Two hundred twenty participants (56%) reported 354 distinct NeuPs. Pharmacological treatments rated helpful for NeuP were non-tramadol opioids (opioids were helpful for 86% of opioid treated NeuPs), cannabinoids (83%), and anti-epileptics (79%). Non-pharmacological treatments rated helpful for NeuP were massage (76%), body position adjustment (74%), and relaxation therapy (70%). Those who used both opioids and exercise reported greater NeuP treatment helpfulness compared to participants using opioids without exercise (P = 0.03). Opioids, cannabinoids, and massage were reported more commonly as helpful than treatments recommended as first-line therapies by current clinical practice guidelines (CPGs) for NeuP after SCI (antiepileptics and antidepressants). Individuals with SCI likely value the modulating effects of pharmacological and non-pharmacological treatments on the affective components of pain in addition to the sensory components of pain when appraising treatment helpfulness.