Management of pain in persons with spinal cord injury

Pain is a common complaint following spinal cord injury (SCI). While nociceptive pain can often be effectively managed by traditional therapies, neurogenic pain is more refractory to treatment. Several categories of pain are recognized in persons with SCI and an accurate diagnosis will improve the therapeutic response. Nociceptive pain is usually perceived to be above or at the level of the cord lesion and is most commonly related to musculoskeletal pathology. Neurogenic pain is usually felt by the patient at or below the neurological level and may be classified as radicular, segmental or deafferentation central pain, depending on its hypothetical origin and the clinical presentation. Management requires recognition of all factors that may influence pain perception and knowledge of the entire range of therapeutic options.