Spinal cord injury pain: mechanisms and management

Curr Pain Headache Rep. 2012 Jun;16(3):207-16. doi: 10.1007/s11916-012-0259-x.


Patients with spinal cord injury (SCI) may experience several types of chronic pain, including peripheral and central neuropathic pain, pain secondary to overuse, painful muscle spasms, and visceral pain. An accurate classification of the patient's pain is important for choosing the optimal treatment strategy. In particular, neuropathic pain appears to be persistent despite various treatment attempts. In recent years, we have gained increasing knowledge of SCI pain mechanisms from experimental models and clinical studies. Nevertheless, treatment remains difficult and inadequate. In line with the recommendations for peripheral neuropathic pain, evidence from randomized controlled treatment trials suggests that tricyclic antidepressants and pregabalin are first-line treatments. This review highlights the diagnosis and classification of SCI pain and recent improvements in the understanding of underlying mechanisms, and provides an update on treatment of SCI pain.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Anticonvulsants / therapeutic use*
  • Antidepressive Agents, Tricyclic / therapeutic use*
  • Female
  • Humans
  • Male
  • Neuralgia / drug therapy
  • Neuralgia / etiology*
  • Pain Measurement
  • Randomized Controlled Trials as Topic
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / drug therapy*
  • Spinal Cord Injuries / physiopathology
  • Visceral Pain / drug therapy
  • Visceral Pain / etiology*


  • Analgesics, Opioid
  • Anticonvulsants
  • Antidepressive Agents, Tricyclic