A Primary Care Provider’s Guide to Pain After Spinal Cord Injury: Screening and Management

Top Spinal Cord Inj Rehabil, 2020 · DOI: 10.46292/sci2603-133 · Published: July 1, 2020

Spinal Cord Injury Healthcare Pain Management

Simple Explanation

Individuals with spinal cord injuries commonly experience chronic pain, which can negatively impact their mental health, sleep, and overall well-being. Primary care providers need to identify different types of pain, such as nociceptive and neuropathic, and use appropriate assessment tools. Effective management involves a mix of pharmacological and nonpharmacological interventions, tailored to the individual's needs. Nonpharmacological options like physical therapy and cognitive behavioral therapy should be explored alongside medications. First-line medications for neuropathic pain include gabapentin, pregabalin, and amitriptyline. It’s crucial to involve patients in their pain management plan, ensuring they are active participants in their care and receive ongoing follow-up.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Chronic pain is highly prevalent among individuals with SCI, significantly affecting their quality of life.
2
Early detection and structured, multidisciplinary treatment approaches are essential for improving outcomes in individuals with SCI and pain.
3
Both pharmacological and nonpharmacological interventions should be utilized to improve outcomes, with treatment plans tailored to the individual's needs and preferences.

Research Summary

The article highlights the importance of primary care providers (PCPs) in managing chronic pain among individuals with spinal cord injury (SCI). It emphasizes the need for PCPs to recognize different types of pain, such as nociceptive and neuropathic, and to utilize appropriate assessment tools for proper classification. Effective pain management involves a combination of pharmacological and nonpharmacological interventions, tailored to the individual's specific needs. Nonpharmacological options like physical therapy, exercise, acupuncture, and cognitive behavioral therapy should be considered alongside medications like gabapentin, pregabalin, and amitriptyline. The article underscores the importance of involving patients as equal stakeholders in their pain management plan, ensuring they are active participants in their care and receive adequate lifelong follow-up. PCPs are encouraged to establish connections with local pain clinics and rehabilitation centers for specialty support.

Practical Implications

Improved Pain Management

Equipping primary care providers with the knowledge and tools to effectively screen and manage pain in SCI patients can lead to better pain control and improved quality of life.

Enhanced Patient-Centered Care

Involving patients in their care plans and providing ongoing support can foster better adherence to treatment and improved outcomes.

Multidisciplinary Approach

Encouraging collaboration between primary care providers, pain specialists, and rehabilitation centers can ensure comprehensive and coordinated care for SCI patients with chronic pain.

Study Limitations

1
Lack of specific guidelines for pain management in SCI patients within primary care settings.
2
Barriers to accessing nonpharmacological therapies, such as cost and availability.
3
Difficulty in interpreting pain symptoms due to altered sensation in SCI patients.

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