Treatment Measures

OTHER COMPLICATIONS OF SPINAL CORD INJURY: PAIN: TREATMENT MEASURES

There are numerous methods of managing SCI pain. Perhaps the most important method involves the commonsense techniques that you can perform to prevent complications and maintain general good health. Other methods include psychological and physical measures, medication, electrostimulation, and surgery.

Disease Prevention and Health Promotion

Pain can be caused or made worse by infections, skin sores, bladder and bowel distention, smoking, emotional stress, spasticity, excessive use, misuse, or disuse, and other noxious stimuli to the body. Avoiding these problems in the first place and treating them promptly and completely if they do occur are the most important way of preventing and managing pain. In general, this is done by proper nutrition, positioning, exercising, and the methods explained elsewhere in this handbook to care for your skin, urinary tract, bowel, and respiratory system.

Psychological and Physical Measures

Pain can also be caused by stress, anxiety, and depression, as well as by improper or excessive activity and inactivity. Therefore, psychological support, recreational and vocational therapy, emphasizing positive or favorable attributes, rather than negative attributes and limitations, training in relaxation techniques, biofeedback, hypnosis, and other ways of achieving your maximum psychosocial adaptation to your injury are also important in the prevention and management of pain in SCI. So too, are physical measures, such as therapeutic exercise to improve your range of motion (ROM), muscle tone, strength, and movement, massage, hydrotherapy, acupuncture, biofeedback, and other physical measures.

Medications

Medications are used to treat pain in SCI if the benefits of the drug are greater than possible side effects. Somatic pain is often treated with non-steroidal anti-inflammatory drugs (NSAIDS) and if necessary injection of steroid and/or anesthetics into the joint. Narcotics are prescribed only if the pain is extreme and disabling, such as interfering with the sleep-wake cycle or preventing participation in therapeutic exercise activities and should be prescribed by a pain specialist. For neuropathic pain, drugs that may be prescribed include antidepressants, tranquilizers, anticonvulsants, and nerve blocks.

Electrostimulation and Surgery

Electrostimulation, or the electrical stimulation of nerves in a variety of locations, and surgery on different parts of the nervous system, are sometimes used to treat specific types of severe, persistent, and disabling pain in SCI.