Effects of intrathecal baclofen on chronic spinal cord injury pain

The pain of 16 patients with spasticity secondary to spinal cord injury was assessed prior to intrathecal baclofen pump implantation and again 6 and 12 months postoperatively. Chronic pain was delineated into neurogenic and musculoskeletal components, noting changes in nature, quality, and severity of pain (visual analogue scale) and use of analgesic medications. Twelve of 16 patients had chronic pain preoperatively and were included in the study. Six patients had neurogenic pain, three had musculoskeletal pain, and three had both pain components. Postoperatively, at both 6- and 12-month intervals, seven patients with neurogenic pain (78%) demonstrated no significant change in pain severity, while in five patients (83%) musculoskeletal pain decreased significantly. Two patients with neurogenic pain (22%) demonstrated an increase in pain severity at both 6- and 12-month intervals. This study suggests that intrathecal baclofen reduces chronic musculoskeletal pain associated with spasticity but does not decrease chronic neurogenic spinal cord injury pain.