Behavioral/Physical and Stimulation Interventions for Chronic Pain Following Spinal Cord Injury: A Systematic Review.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Pain Management

Background:

• Chronic pain is a significant issue for individuals with spinal cord injury (SCI).
• Previous reviews indicated insufficient evidence for nonpharmacological interventions in SCI chronic pain.
• This study addresses the need for updated evidence on nonpharmacological approaches.

Purpose of the Study:

• To systematically review and evaluate recent literature on nonpharmacological interventions for chronic pain in adults with SCI.
• To assess the efficacy of behavioral, complementary, and alternative medicine interventions.

Main Methods:

• Searched multiple databases (MEDLINE, Cochrane, Scopus, CINAHL, PsycINFO) for articles published between 2013 and August 2023.
• Included studies involving adults (≥18 years) with traumatic SCI and chronic pain, comparing nonpharmacological interventions to control groups.
• Assessed study quality and risk of bias using established guidelines (Hawker, RoB2, ROBINS-I).

Main Results:

• 2961 articles were identified; 26 met inclusion criteria for data extraction.
• 15 studies focused on behavioral/physical interventions, and 11 on stimulation interventions.
• Cognitive behavioral therapy (CBT) and its variants demonstrated effectiveness, especially for neuropathic pain.

Conclusions:

• Cognitive behavioral therapy (CBT) is recommended for managing neuropathic pain post-SCI, supported by existing evidence.
• Stimulation interventions require further standardization and robust evidence for clinical adoption in SCI pain management.
• Individualized treatment approaches are crucial for optimizing outcomes in chronic SCI pain.