Annals of physical and rehabilitation medicine
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Conduct a literature review on the organization models for the chronic neuropathic pain management of spinal cord injury (SCI) patients. ⋯ Specific pain management centers or hospital units remain the benchmark place for chronic pain in SCI patients. PM&R physicians play a key role in the care management of chronic SCI pain. The partnership PM&R-Pain management center aims to provide the most efficient and coordinated care for SCI patient.
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Ann Phys Rehabil Med · Mar 2009
Practice GuidelineChronic neuropathic pain in spinal cord injury patients: what relevant additional clinical exams should be performed?
Study the indications and level of evidence of clinical exams that might be relevant in exploring the causes of neuropathic pain in spinal cord injury patients. ⋯ For the neuropathic pain of spinal cord injury patients' additional clinical exams should be used in the framework of an etiological diagnosis.
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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
Chronic neuropathic pain in spinal cord injury: efficiency of deep brain and motor cortex stimulation therapies for neuropathic pain in spinal cord injury patients.
In spite of all the scientific advances in pharmacological research, a great number of patients cannot efficiently manage their chronic pain with conventional pharmacological treatments. Brain stimulation techniques have considerably improved these last 10 years. These techniques could be an interesting option after a rigorous selection of patients. We aim to evaluate the efficacy of brain stimulation (deep brain stimulation [DBS] and motor cortex stimulation [MCS]) within the framework of neuropathic pain management in spinal cord injury (SCI) patients and elaborate some recommendations. ⋯ For central pain in SCI patients, there is no sufficient level of evidence to validate the use of DBS. There is however a low level of evidence for MCS. These results must be validated by larger comparative or controlled versus placebo clinical studies.
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain in spinal cord injury patients: what is the impact of social and environmental factors on care management?
In order to refine therapeutic strategies for spinal cord injury (SCI) patients with chronic neuropathic pain, it appears essential to assess the impact of socioenvironmental factors on the onset of pain or its chronic nature. The aim of this article is to answer the following question regarding these factors: is there any evidence that managing these social and environmental factors could have a positive impact on the treatment of chronic neuropathic pain in SCI patients? ⋯ It was impossible to directly answer this question based on the literature review only. Nonetheless, some socioenvironmental factors can be considered as potential triggering factors for the onset of chronic pain in spinal cord injury patients, i.e. a low degree of independence (C), low socioeconomic status (B), unemployment (B), and family and friends with a "negative attitude" (C).