Page 2

K - Ameliorate Neuropathic Pain

Ameliorate Neuropathic Pain | Body Structure and Function C Short, MD; C O’Connell, MD; C Craven, MD; and the E-Scan Investigative Team Neuropathic pain (NeP) - reported in about 40% of individuals with spinal cord injury (SCI) - is a common and severe type of pain resulting from damage to the spinal cord and or peripheral nerves.1 This damage causes abnormal, painful sensations in the body, even when there is no identifiable or visible cause of the pain. NeP can occur anywhere in the body below the level of injury, and develop in any individual with SCI, regardless of the level (cervical, thoracic or lumbar) or extent of cord damage (completeness of injury).2-6 Individuals with NeP often report painful sensations of heat, cold, and electric-like shocks, and even normal sensations - like a breeze or light touch - can cause severe pain (Figure 1.0). This type of pain can be so horrible that individuals indicate they are willing to trade a cure for their paralysis, for pain relief. In addition to NeP, individuals with SCI also suffer from soft tissue and joint pain. As a result, two-thirds will develop chronic pain. Pain has many negative effects: social isolation, unemployment, decreased function, decreased quality of life, depression and even suicide.7-10 Musculoskeletal pain seems more manageable with our current treatments, while NeP is much more difficult to control. Individuals with SCI, and NeP rarely experience spontaneous remission.6 In fact, over time, pain increases in 47% of these individuals, and decreases in only 7%.6 Seventy-seven percent of individuals with SCI indicate that pain always interferes with one or more of their daily activities. Pain affects sleep in 40%, exercise in 35%, and work in 34% of those who are employed.7 Eleven percent of people report that pain, rather than loss of function, is the main factor preventing them from engaging in work. Figure 1.0 events that lead to development of NeP, folowing SCI. When a peripheral nerve or a central nerve pathwa y for pain is damaged , it can triger upregulation of pain receptors , peripheraly and centraly, leading to persistent abnormal pain sensations . It can also triger changes in the brain and spinal cord that lead to non-pain ful stimuli becoming pain ful. Reproduced from Baron.8 © 2006 Nat ure Publishing Group. Reprinted with permision. A A A/A C C Opioid receptor Glutamate receptor NE/5-HT receptor GABA receptor -adrenoceptor TRPV1 receptor AMPA/KA receptor Sodium channel Calcium channel (2 subunit) Spinal cord dorsal horn + A B C D C AMELIORATE NEUROPATHIC PAIN | BODY STRUCTURE AND FNUCTION 107


K - Ameliorate Neuropathic Pain
To see the actual publication please follow the link above