Abstract
Objective
To update a systematic review of published research on pharmacotherapy for pain post-spinal
cord injury (SCI).
Data Sources
PubMed/MEDLINE, CINAHL, Embase, and PsycINFO databases were searched for articles
from 2009 to September 2015 examining treatment of pain post-SCI.
Study Selection
Studies were included for analysis if they met the following 4 a priori criteria:
(1) written in the English language; (2) ≥50% of subjects had an SCI, unless results
were stratified by population type; (3) participants included ≥3 subjects with an
SCI; and (4) any intervention involving pharmacologic treatment for the improvement
of pain.
Data Extraction
Randomized controlled trials were assessed for methodologic quality using the Physiotherapy
Evidence Database scoring system. All research designs were given a level of evidence
according to a modified Sackett Scale.
Data Synthesis
Seven new studies met our inclusion criteria. The new studies fell into the following
categories: analgesics (n=1), anticonvulsants (n=2), antidepressants (n=2), antispastics
(n=1), and cannabinoids (n=1). There was evidence for 5 new pharmacotherapies among
the SCI population; these included the following: oxycodone, duloxetine, venlafaxine,
phenol block, and dronabinol. Levels of evidence for all therapy modalities were updated
based on the new evidence.
Conclusions
Anticonvulsants remain the most studied and supported pharmacotherapy for neuropathic
pain post-SCI. Antidepressants showed reduction in pain only among those with comorbid
depression. Botulinum toxin and phenol blocks were supported for the reduction of
mixed pain post-SCI.
Keywords
List of abbreviations:
PEDro (Physiotherapy Evidence Database), RCT (randomized controlled trial), SCI (spinal cord injury), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 12, 2016
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
