Survey on current treatments for pain after spinal cord damage

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0160-5 · Published: January 24, 2019

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

This study examines how doctors around the world treat pain caused by spinal cord injuries. The researchers surveyed doctors to see what kinds of treatments they use, including both medications and other therapies like acupuncture or mindfulness. They also looked at whether the treatments differed between wealthier and less wealthy countries. The survey found that most doctors use a combination of treatments for pain after spinal cord injury. However, there were significant differences in the use of medications and other therapies between doctors in developed countries and those in developing countries. For instance, doctors in developing countries were less likely to use medical cannabis or acupuncture. The study suggests that there's a growing interest in using medical cannabis for pain relief among doctors who treat spinal cord injuries. Many doctors believe it should be available to patients, but policies and regulations may be slow to catch up with this interest.

Study Duration

6 Months

Participants

153 clinicians who care for individuals with SCD

Evidence Level

Not specified

Key Findings

1
Most spinal cord medicine clinicians employ a multimodal approach to pain, indicating that individualized and multimodal strategies are common.
2
Clinicians are not necessarily offering data-driven pain treatments but may be tailoring their treatments to patients’ desires and subjective responses.
3
There are significant differences in the utilization of pharmacologic and non-pharmacologic approaches to SCD-related pain between clinicians from more and less developed countries.

Research Summary

The study assessed the international spinal cord medicine and rehabilitation community’s utilization of pharmacological and non-pharmacological treatments for spinal cord damage (SCD)-related pain. Most spinal cord medicine clinicians employ a multimodal approach to pain, and approaches to pain in SCD are often individualized. There are significant differences in utilization of pharmacologic and non-pharmacologic approach to SCD-related pain between clinicians from more and less developed countries.

Practical Implications

Clinical Practice

The findings suggest the need for individualized and multimodal approaches to pain management in SCD patients.

Resource Allocation

The study highlights disparities in treatment availability between developed and developing nations, suggesting a need for equitable resource allocation.

Future Research

The results prompt further exploration of the reasons behind differences in pain treatment approaches between developed and developing nations and the potential of medical cannabis.

Study Limitations

1
The survey was available only in English, limiting access to those who are relatively fluent in the language.
2
The distribution strategy likely resulted in selection bias, as clinicians and staff working in academic institutions were more likely to receive the survey.
3
The study received no responses from colleagues in Africa or South America and a relative paucity of surveys from individuals living in developing countries.

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