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. 2024 Jul;47(4):465-476.
doi: 10.1080/10790268.2023.2218186. Epub 2023 Jul 10.

The effect of neuropathic pain treatments on pain interference following spinal cord injury: A systematic review

David J Allison  1 , Jessica Ahrens  1 , Magdalena Mirkowski  1 , Swati Mehta  1   2 , Eldon Loh  1   2
Affiliations

The effect of neuropathic pain treatments on pain interference following spinal cord injury: A systematic review

David J Allison et al. J Spinal Cord Med. 2024 Jul.

Abstract

Context: Neuropathic pain is a common and debilitating condition following SCI. While treatments for neuropathic pain intensity have been reviewed, the impact on pain interference has not been summarized.

Objective: To systematically review the effect of neuropathic pain interventions on pain interference in individuals with spinal cord injury.

Methods: This systematic review included randomized controlled trials and quasi-experimental (non-randomized) studies which assessed the impact of an intervention on pain interference in individuals with spinal cord injury and neuropathic pain. Articles were identified by searching MEDLINE (1996 to April 11, 2022), EMBASE (1996 to April 11, 2022), PsycInfo (1987 to April, week 2, 2022). Studies were assessed for methodologic quality using a modified GRADE approach and were given quality of evidence (QOE) scores on a 4-point scale ranging from very low to high.

Results: Twenty studies met the inclusion criteria. These studies fell into the following categories: anticonvulsants (n = 2), antidepressants (n = 1), analgesics (n = 1), antispasmodics (n = 1), acupuncture (n = 2), transcranial direct current stimulation (n = 1), active cranial electrotherapy stimulation (n = 2), transcutaneous electrical nerve stimulation (n = 2), repetitive transcranial magnetic stimulation (n = 1), functional electrical stimulation (n = 1), meditation and imagery (n = 1), self-hypnosis and biofeedback (n = 1), and interdisciplinary pain programs (n = 4).

Conclusion: When considering studies of moderate to high quality, pregabalin, gabapentin, intrathecal baclofen, transcranial direct current stimulation, and transcutaneous electrical nerve stimulation (in 1 of 2 studies) were shown to have beneficial effects on pain interference. However, due to the low number of high-quality studies further research is required to confirm the efficacy of these interventions prior to recommending their use to reduce pain interference.

Keywords: Neuropathic pain; Pain interference; Spinal cord injury.

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Figures

Figure 1
Figure 1
Flow diagram for the identification, screening, eligibility, and inclusion of studies.
See this image and copyright information in PMC

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