Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

P - NEUROPATHIC PAIN




Transcutaneous electrical nerve stimulation (TENS) may be considered for the reduction of neuropathic pain intensity among individuals with SCI. (CANPAIN TREAT 2016, p.S17; Level C)

The dorsal root entry zone (DREZ) procedure may be considered in exceptional circumstances and as a last resort for reducing neuropathic pain intensity among individuals with SCI. (CANPAIN TREAT 2016, p.S17; Level C)

Clinical considerations:

Evidence of benefit for the DREZ procedure exists, but the risk of the procedure does not justify its use beyond exceptional circumstances. Risks associated with the DREZ procedure include paresis, neuropathy or radiculopathy, ataxia and a variety of surgical complications such as persistent incisional site pain, cerebrospinal fluid leak, wound infection, subcutaneous hematoma, and bacteremia.

Levetiracetam should not be used for reducing neuropathic pain intensity among individuals with SCI. (CANPAIN TREAT 2016, p.S18; Level A)
Mexiletine should not be used for reducing neuropathic pain intensity among individuals with SCI. (CANPAIN TREAT 2016, p.S18; Level A)