TY - JOUR
T1 - Neuropathic pain in spinal cord injury
T2 - topical analgesics as a possible treatment
AU - Crul, T. C.
AU - Stolwijk-Swüste, J. M.
AU - Kopsky, D. J.
AU - Visser-Meily, J. M.A.
AU - Post, M. W.M.
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to International Spinal Cord Society.
PY - 2020/8/13
Y1 - 2020/8/13
N2 - Study design: Review of the literature and semi-structured interviews. Objective: To explore the possible use of topical analgesics for the treatment of neuropathic pain (NP) in spinal cord injury (SCI). Setting: Institute for Neuropathic Pain, Soest, The Netherlands. Methods: A review was performed of studies on topical analgesics for SCI-related NP published up to May 2019. In addition, eight persons with SCI-related NP who were treated with topical analgesics were interviewed in a semi-structured interview on their experience with topical analgesics. Results: Seven studies (five case reports and two case series) were found that evaluated the use of topical analgesics for SCI-related NP. None of the studies used a control treatment. Topical analgesics included baclofen, ketamine, lidocaine, capsaicin, and isosorbide dinitrate. All studies reported a decrease in NP over time. Persons interviewed were 49–72 years of age and all but one had an incomplete SCI. They used topical agents containing phenytoin, amitriptyline, baclofen, ketamine or loperamide. All showed a decrease in pain of at least 3 points on the 11-point numeric rating scale during this treatment. Discussion/conclusions: Evidence on the use of topical analgesics in SCI is scarce. Case reports, case series and interviews suggest that the use of topical analgesics can be beneficial in treating SCI-related NP. Placebo-controlled studies are required to investigate the effect of topical analgesics on SCI-related NP.
AB - Study design: Review of the literature and semi-structured interviews. Objective: To explore the possible use of topical analgesics for the treatment of neuropathic pain (NP) in spinal cord injury (SCI). Setting: Institute for Neuropathic Pain, Soest, The Netherlands. Methods: A review was performed of studies on topical analgesics for SCI-related NP published up to May 2019. In addition, eight persons with SCI-related NP who were treated with topical analgesics were interviewed in a semi-structured interview on their experience with topical analgesics. Results: Seven studies (five case reports and two case series) were found that evaluated the use of topical analgesics for SCI-related NP. None of the studies used a control treatment. Topical analgesics included baclofen, ketamine, lidocaine, capsaicin, and isosorbide dinitrate. All studies reported a decrease in NP over time. Persons interviewed were 49–72 years of age and all but one had an incomplete SCI. They used topical agents containing phenytoin, amitriptyline, baclofen, ketamine or loperamide. All showed a decrease in pain of at least 3 points on the 11-point numeric rating scale during this treatment. Discussion/conclusions: Evidence on the use of topical analgesics in SCI is scarce. Case reports, case series and interviews suggest that the use of topical analgesics can be beneficial in treating SCI-related NP. Placebo-controlled studies are required to investigate the effect of topical analgesics on SCI-related NP.
UR - http://www.scopus.com/inward/record.url?scp=85089382772&partnerID=8YFLogxK
U2 - 10.1038/s41394-020-00321-1
DO - 10.1038/s41394-020-00321-1
M3 - Article
C2 - 32792476
AN - SCOPUS:85089382772
SN - 2058-6124
VL - 6
JO - Spinal cord series and cases
JF - Spinal cord series and cases
IS - 1
M1 - 73
ER -