Annals of physical and rehabilitation medicine
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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).
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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
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 in patients with spinal cord injury. What is the efficacy of regional interventions? Sympathetic blocks, nerve blocks and intrathecal drugs.
To elaborate recommendations regarding neuropathic pain management in spinal cord injury patients. The goal was to evaluate the efficacy of local anesthetic therapeutics including intrathecal or epidural treatments, sympathetic and nerve blocks. ⋯ There is not a sufficient level of proof to recommend using IT or epidural drug delivery for treating neuropathic pain. However, according to the clinical practices data reviewed, we can suggest to conduct further studies on the impact of IT baclofen delivery that seems to have a pain-relieving impact in some situations. It would be interesting to identify the subgroups of patients that could benefit from this treatment.
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Ann Phys Rehabil Med · Mar 2009
What is the efficacy of physical therapeutics for treating neuropathic pain in spinal cord injury patients?
Evaluate the place and level of proof of physical therapeutics for treating neuropathic pain in spinal cord injury (SCI) patients. ⋯ To this day, no study can validate the integration of physical therapy as part of the array of therapeutics used for treating neuropathic pain in SCI patients. In the future, it will require controlled and randomized therapeutic studies on homogenous groups of SCI patients, to control the various confusion factors.