Chapter 46 Pain following spinal cord injury

Abstract

Publisher Summary This chapter explores that spinal cord injury (SCI) has a number of severe and disabling consequences. Although loss of function is often considered the primary issue, pain is also a major problem. In central pain conditions, small randomized trials have shown the effectiveness of amitriptyline and lamotrigine in central post-stroke pain and of dronabinol, a cannabinoid, in pain in multiple sclerosis. It is not known whether the efficacy of drugs in other central or peripheral neuropathic pain conditions can be anticipated to have similar effects in SCI neuropathic pain. Central neuropathic pain is often considered more refractory than peripheral neuropathic pain. It has been suggested that central post-stroke pain responds better to antidepressants than SCI pain. The chapter also reviews that because of the lack of sufficient data in neuropathic SCI pain, efficacy in other neuropathic pain conditions has to be considered in choosing treatment.