Intractable Abdominal Pain in a Patient With Spinal Cord Injury: A Case Report

Annals of Rehabilitation Medicine, 2013 · DOI: http://dx.doi.org/10.5535/arm.2013.37.5.721 · Published: October 1, 2013

Simple Explanation

Patients with spinal cord injuries can experience various types of chronic pain, including abdominal pain. This case report focuses on a patient with spinal cord injury who developed intractable abdominal pain. The patient's abdominal pain was not related to any visceral pathology or musculoskeletal origin. Instead, it was determined to be neuropathic pain, which is caused by damage to the nerves. Initial pain management with oral medications was not effective. However, an intrathecal lidocaine injection provided considerable pain relief, suggesting a potential treatment option for similar cases.

Study Duration

Not specified

Participants

A 37-year-old male patient

Evidence Level

Case Report

Key Findings

1
The patient experienced intractable abdominal pain localized in the periumbilical area, unrelated to visceral or musculoskeletal issues, following a spinal cord injury.
2
The pain was identified as neuropathic based on the Douleur Neuropathique 4 (DN4) questionnaire and dermatomal pattern correlation within the level of injury.
3
Intrathecal lidocaine injection resulted in a remarkable decrease in pain level, offering significant but not long-term relief.

Research Summary

This case report describes a patient with spinal cord injury (SCI) who experienced intractable abdominal pain, which was diagnosed as neuropathic pain. The patient's pain did not respond adequately to oral medications, but intrathecal lidocaine injections provided significant pain relief. The report suggests that intrathecal injections of local anesthetics may be a viable treatment option for intractable neuropathic abdominal pain in SCI patients when oral medications are ineffective.

Practical Implications

Diagnostic Importance

Consider neuropathic pain as a potential cause of abdominal pain in SCI patients, especially when visceral and musculoskeletal causes have been ruled out.

Treatment Strategy

Explore intrathecal lidocaine injections as a possible treatment option for intractable neuropathic abdominal pain in SCI patients when oral medications fail.

Further Research

Conduct further research on the long-term efficacy and safety of intrathecal lidocaine injections for managing neuropathic pain in SCI patients.

Study Limitations

1
Lack of long-term follow-up data on the duration of the effect of intrathecal lidocaine administration.
2
The findings are based on a single case report, limiting generalizability.
3
Further data is needed on the long-term efficacy of intrathecal administration of lidocaine

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