Neuropathic Pain in People with Spinal Cord Injury: Quantitative Clinical Trials

One of the biggest problems of spinal cord injuries (SCI) is neuropathic pain. Moreover, it is pointed out by several studies as one of the major difficulties for SCI patients. Nowadays, the current challenge is to understand the etiology of the neuropathic pain in SCI patients. The objective of this study is use from quantitative clinical trials to observe the differences between spinal cord injuries who have neuropathic pain and those who do not. 30 individuals separated in 3 groups: 10 SCI with neuropathic pain (SCI-P); 10 SCI without neuropathic pain (SCI-NP); 10 controls (non-SCI subjects). They were submitted with quantitative tests: tactile and thermal sensitivity, evoked pain (allodynia, dysesthesia and hyperalgesia) and the McGill Pain Questionnaire. All SCI individuals do neuromuscular electrical stimulation. SCI-NP detected more cold, heat pain, and tolerance of heat pain than the SCI-P. The SCI-P detected more heat than the SCI-NP. There was no statistical significance between the groups SCIP and SCI-NP when comparing pain and tactile sensitivity, but SCI-P reported more tactile sensitivity than the SCI-NP. Hyperalgesia below the level of injury was most often detected by SCI-NP. This study has replicated clinically some of the diverse mechanisms of neuropathic pain, gathering and quantifying various forms of sensitivity affected by the injury. We demonstrate that neuropathic pain after traumatic SCI is not due to only anatomic lesion, but also related to complex neural processes, biochemical, and physiological prior uncorrelated, thus contributing to better solidify the knowledge about this area.