Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain

Frontiers in Pain Research, 2022 · DOI: 10.3389/fpain.2022.991736 · Published: August 24, 2022

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

Spinal cord injuries can lead to chronic pain that significantly impacts daily life. Current drug treatments often don't work well and have side effects. This review explores non-drug therapies like exercise, psychological help, and diet changes to manage this pain. Non-pharmacological treatments are safer alternatives that can be speciﬁcally tailored to the individual and used in tandem with pharmacological therapies if needed. This review describes existing non-pharmacological therapies that have been used to treat SCI-induced pain in both preclinical models and clinical populations. Because chronic pain, including SCI pain, is complex and has both emotional and physiological components, treatment should be multidisciplinary in nature and ideally tailored speciﬁcally to the patient.

Study Duration

Not specified

Participants

Preclinical models and clinical populations with SCI-induced pain

Evidence Level

Review

Key Findings

1
Exercise, including arm ergometry and treadmill training, shows promise in reducing SCI-induced pain and improving quality of life.
2
Anti-inflammatory, ketogenic, and low FODMAP diets may alleviate pain by reducing inflammation and improving gut health in SCI patients.
3
Psychological interventions like cognitive behavioral therapy, mindfulness, and meditation can help patients cope with pain, reduce anxiety and depression, and improve overall well-being.

Research Summary

Chronic pain is a common and challenging problem after spinal cord injury (SCI), often resistant to traditional drug treatments. Non-pharmacological therapies offer a promising alternative or complement to these drugs. Non-pharmacological interventions such as exercise, dietary changes, and psychological support can address multiple mechanisms contributing to SCI-induced pain, offering whole-body effects and fewer side effects. Further research is needed, particularly on treatments for neurogenic bowel and bladder dysfunction, and on tailoring treatments to individual patient pain profiles for optimal benefit.

Practical Implications

Personalized Treatment Plans

Tailoring treatment plans to individual pain phenotypes can improve the effectiveness of both pharmacological and non-pharmacological interventions.

Multidisciplinary Approach

Adopting a multidisciplinary approach that includes physical, psychological, and dietary interventions can address the complex nature of SCI-induced pain.

Further Research

More research is needed to explore non-pharmacological treatments for neurogenic bowel and bladder dysfunction and to understand sex differences in pain and inflammation.

Study Limitations

1
Limited research on non-pharmacological interventions for SCI-induced visceral pain and gastrointestinal/bladder disorders.
2
Many pre-clinical studies are carried out primarily in female rodents, limiting understanding of sex differences.
3
Non-pharmacological therapies are not always successful in all individuals with SCI pain.

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