Targeting inflammation as a treatment modality for neuropathic pain in spinal cord injury: a randomized clinical trial

J Neuroinflammation. 2016 Jun 17;13(1):152. doi: 10.1186/s12974-016-0625-4.


Background: The purpose of the present study was to examine the effectiveness of an anti-inflammatory intervention as a treatment for neuropathic pain following spinal cord injury (SCI).

Methods: This randomized, parallel-group, controlled clinical trial (NCT02099890) examined 20 participants with varying levels and severities of SCI, randomized (3:2) to either a 12-week anti-inflammatory diet, or control group. Outcome measures consisted of self-determined indices of pain as assessed using the neuropathic pain questionnaire (NPQ) and markers of inflammation as assessed by various pro- and anti-inflammatory cytokines, as well as the eicosanoids PGE2 and LTB4.

Results: A significant group × time interaction was found for sensory pain scores (p < 0.01). A Mann-Whitney test revealed that the change scores (3-month baseline) were significantly different between groups for IFN-y (U = 13.0, p = 0.01), IL-1β (U = 14.0, p = 0.01), and IL-2 (U = 12.0, p = 0.01). A Friedman test revealed the treatment group had a significant reduction in IFN-y (x (2) = 8.67, p = 0.01), IL-1β (x (2) = 17.78, p < 0.01), IL-6 (x (2) = 6.17, p < 0.05), while the control group showed no significant change in any inflammatory mediator. A stepwise backward elimination multiple regression analysis showed that the change in sensory neuropathic pain was a function of the change in the proinflammatory cytokines IL-2 and IFN-y, as well as the eicosanoid PGE2 (R = 0.689, R (2) = 0.474).

Conclusions: Overall, the results of the study demonstrate the efficacy of targeting inflammation as a means of treating neuropathic pain in SCI, with a potential mechanism relating to the reduction in proinflammatory cytokines and PGE2.

Trial registration:, NCT02099890.

Keywords: Anti-inflammatory diet; Inflammation; Neuropathic pain; Spinal cord injury.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antioxidants / administration & dosage*
  • Diet, Carbohydrate-Restricted / methods
  • Diet, Protein-Restricted / methods
  • Female
  • Humans
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / blood*
  • Male
  • Middle Aged
  • Neuralgia / blood*
  • Neuralgia / diagnosis
  • Neuralgia / diet therapy*
  • Spinal Cord Injuries / blood*
  • Spinal Cord Injuries / diagnosis
  • Spinal Cord Injuries / diet therapy*
  • Treatment Outcome


  • Antioxidants
  • Inflammation Mediators