Non-opioid pharmacologic treatment of chronic spinal cord injury-related pain

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1730109 · Published: April 1, 2022

Spinal Cord Injury Pharmacology Pain Management

Simple Explanation

Spinal cord injury-related pain significantly impairs physical health, psychological wellbeing, and quality of life. Given the opioid abuse crisis, non-opioid medications should be prioritized. This review examines non-opioid medication options for spinal cord injury-related pain, considering the specific challenges these individuals face. Antiepileptic drugs and antidepressants show the most promise for treating chronic spinal cord injury-related pain, but treatment should be customized.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review Article

Key Findings

1
Antiepileptic drugs like pregabalin and gabapentin have demonstrated efficacy in managing chronic SCI-related neuropathic pain.
2
Tricyclic antidepressants (TCAs) are often considered first-line treatments, especially when comorbid depression is present.
3
Further research is needed to understand the potential roles of calcitonin, lithium, and marijuana in treating SCI-related pain.

Research Summary

Chronic pain after spinal cord injury significantly affects quality of life, necessitating a shift towards non-opioid treatments due to the opioid crisis. The review highlights antiepileptic and antidepressant medications as primary non-opioid options, emphasizing individualized treatment strategies. Future research should focus on matching treatments to individual genotypes and pain phenotypes, and further explore the potential of calcitonin, lithium and marijuana.

Practical Implications

Individualized Treatment Plans

Clinicians should tailor treatment strategies to each patient's unique clinical situation, weighing medication risks and benefits.

Prioritize Non-Opioid Options

Given the risks associated with opioids, non-opioid pharmacologic options should be explored and optimized for SCI-related pain.

Further Research Needed

More research is needed to fully understand the potential of medications like calcitonin, lithium, and marijuana in treating SCI-related pain.

Study Limitations

1
Limited evidence for some non-opioid medications in the SCI population.
2
Variability in study techniques and outcome measures affecting pain statistics.
3
The complex clinical situation of each individual patient must be weighed against the risks and benefits of each medication.

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