Comprehensive pain management in spinal cord injury: Rehabilitation approaches

Winser, S. J. (Invited speaker)

Activity: Talk or presentationInvited talk


Pain initiated by lesions of the central nervous system, including the cortical and sub-cortical regions of the brain, brainstem, and spinal cord, are classified as central neuropathic pain (cNeP). cNeP secondary to spinal cord injury (SCI) is common and is reported among 65% to 80% of all cases. The pain is characterised by a throbbing clinical presentation and sensory impairments, manifested as the absolute or partial decline in sensory responses, resulting in pain, paraesthesia, and dysesthesia. 60% of the individuals reporting cNeP secondary to SCI have a cervical lesion. Cervical lesions disrupt larger proportion of spinal pathways when compared to thoracic and lumbar level lesions resulting in more pain. The International Association for the Study of Pain (IASP) categorises pain in SCI as either neuropathic or nociceptive in origin. Further, the neuropathic pain is classified into; at the level of lesion, below the level or above the level pain. The neural mechanisms underlying the pain are diverse and few of the widely accepted hypotheses includes: micgroglial action and pain signalling for pain below the level of lesion, intracellular signalling mechanism in the central sensitization for pain at-the level of lesion and peripheral sensitization for pain above the level of lesion. cNeP secondary to SCI remain a serious problem with debilitating consequences, due to the lack of clear understanding about the neural mechanism in human subjects, thereby making it difficult to develop reliable treatment modalities. Nonetheless, Different forms of Physiotherapeutic interventions have been administered to relieve cNeP secondary to SCI. This study aimed to pool the findings of studies evaluating the efficacy of physiotherapy interventions for managing cNeP among individuals with SCI.
Period5 Sep 202017 Oct 2020
Event titleThe World Spinal Cord Injury Day Webinar Series 2020: null
Event typeSeminar
LocationBangaluru, India
Degree of RecognitionInternational