Annals of physical and rehabilitation medicine
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Ann Phys Rehabil Med · Mar 2009
Practice GuidelineNeuropathic pain in spinal cord injury: identification, classification, evaluation.
Chronic pain is very frequent after spinal cord injury, recent data showing that at least 80% of the patients experience pain, one-third at a severe level. The main objective of the present work is to report and discuss data regarding tools and procedures for the screening, diagnosis, and evaluation of neuropathic pain in spinal cord injury patients. ⋯ The DN4 questionnaire can be used for the screening and identification of neuropathic pain in this population of patients, often suffering from various types of pain. The use of the Spinal Cord Injury Pain Task Force of the International Association of the Study of Pain classification (SCIP-IASP), although some limitations, is recommended since taking into account physiopathology, localisation, and nature of pain. Daily uses of Visual Analogic Scale (VAS) or Numeric Scale (NS) are an obvious need and that of the questionnaire Douleur de Saint-Antoine (QDSA) for global evaluation and more specifically of the Neuropathic Pain Symptom Inventory (NPSI) for neuropathic pain are highly recommended.
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain in spinal cord injured patients: what is the effectiveness of surgical treatments excluding central neurostimulations?
Analyzing the literature and elaborating recommendations on the following topics: relevance of dorsal root entry zone (DREZ) lesions, surgical treatment for posttraumatic syringomyelia, other therapeutic approaches (peripheral nerve root pain, nerve trunk pain and Sign Posterior Cord [SCI] pain). ⋯ The literature review can define the relevance of surgical treatments on some types of SCI pain. However, the results of many articles are difficult to analyze, as they do not report clinical or follow-up data.
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Ann Phys Rehabil Med · Mar 2009
The chronic neuropathic pain of spinal cord injury: which efficiency of neuropathic stimulation?
Determine the efficacy of spinal cord stimulation (SCS) for treating neuropathic pain in spinal cord injury (SCI) patients. ⋯ There is no significant level of proof to recommend the use of this technique in this indication. Conducting further studies, either physiological or clinical, could help to promote this technique with very minor adverse effects in an indication which, to this day, has no gold standard.
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Ann Phys Rehabil Med · Mar 2009
What are the risk factors of occurence and chronicity of neuropathic pain in spinal cord injury patients?
Analyze the epidemiological data on neuropathic pain in spinal cord injury patients and determine the risk factors for its occurrence and chronicity. ⋯ Neuropathic pain in SCI patients is a major issue, its determining factors still need to be evaluated properly by refining the epidemiological data.
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain of spinal cord injury: what is the effectiveness of psychocomportemental management?
To determine the efficacy of treating neuropathic pain in spinal cord injury (SCI) patients by psychological, cognitive or behavioral therapies and suggest recommendations for clinical practices. ⋯ There is no scientific evidence for validating this type of pain management care. However, the high level of evidence of the articles studying the efficacy of these therapies in patients with chronic pain suggest that it could be applied to SCI patients. These techniques must be developed in France and further studies should be conducted on SCI patients affected by neuropathic pain.