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Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: a multicenter cross-sectional survey

Abstract

Study design

Cross-sectional survey.

Objectives

The objective of the study was to identify the treatments that people with traumatic spinal cord injury (SCI) used for their non-neuropathic pains (nonNeuPs) and how they subjectively rated the helpfulness of those treatments.

Setting

Six centers from the Spinal Cord Injury Model Systems.

Methods

Three hundred ninety one individuals who were at least 1-year post-traumatic SCI were enrolled. A telephone survey was conducted for pharmacologic and non-pharmacologic treatments utilized in the last 12 months for each participant’s three worst pains and the perceived helpfulness of each treatment for each pain.

Results

One hundred ninety (49%) participants reported at least one nonNeuP (Spinal Cord Injury Pain Instrument score < 2) in the previous 7 days. NSAIDs/aspirin, acetaminophen, opioids, and cannabinoids were the most commonly used and helpful pharmacologic treatments for overall nonNeuP locations (helpful in 77–89% of treated pains). Body position adjustment, passive exercise, massage, resistive exercise, and heat therapy were reported as the most commonly used non-pharmacological treatments for nonNeuPs. Heat therapy, aerobic exercise, massage, and body position adjustment were the most helpful non-pharmacological treatments for overall nonNeuP locations (helpful in 71–80% of treated pains). Perceived helpfulness of treatments varied by pain locations, which may be due to different mechanisms underlying pains in different locations.

Conclusions

Results of the study may help guide clinicians in selecting pain-specific treatments for nonNeuPs. The self-reported helpfulness of heat therapy, exercise, and massage suggests a possible direction for clinical trials investigating these treatments of nonNeuP while limiting the side effects accompanying pharmacologic treatments.

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Data availability

The data generated and analyzed during the current study are available through the SCIMSs upon request.

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Acknowledgements

The authors would like to acknowledge the data collectors in the SCIMSs centers.

Funding

The contents of this paper were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SI5017, 90SI5023, 90SI5018, 90SI5015, 90SI5019, and 90DP0083). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this paper do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

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Contributions

CYT was responsible for designing the work that led to the submission, acquiring and analyzing the data, interpreting results, and drafting and revising the paper. TNB was responsible for designing the work that led to the submission, interpreting results, and drafting part of the paper. ADD was responsible for designing the work that led to the submission, screening/recruiting eligible participants, and acquiring and analyzing the data. SM, BM, and SC were responsible for designing the work that led to the submission, interpreting results, and revising the paper. ERF was responsible for designing the work that led to the submission, analyzing the data, interpreting the results, and revising the paper.

Corresponding author

Correspondence to Chung-Ying Tsai.

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The authors declare no competing interests.

Ethical approval

Institutional Review Board approval (HSM# 11-01603) was obtained prior to conducting any study related procedures, and informed consent was obtained from each participant. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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Tsai, CY., Bryce, T.N., Delgado, A.D. et al. Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: a multicenter cross-sectional survey. Spinal Cord (2021). https://doi.org/10.1038/s41393-021-00621-9

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