Dolor en la persona con lesión medular
DOI:
https://doi.org/10.28957/rcmfr.369Palabras clave:
Lesión medular, dolor neuropático, dolor musculoesquelético, gabapentinoides, antidepresivosResumen
El dolor es una complicación frecuente luego de una lesión medular y afecta la calidad de vida de la persona que lo sufre. Puede ser de causa musculoesquelética, visceral o, el más difícil de tratar, el neuropático. Este artículo resume los distintos tipos de dolor, su fisiopatología y las opciones terapéuticas, tanto farmacológicas como de otros tipos, que se le pueden ofrecer al paciente.
Referencias bibliográficas
Van Gorp S, Kessels AG, Joosten EA, Van Kleef M, Patijn J. Pain prevalence and its determinants after spinal cord injury: a systematic review. Eur J Pain. 2015;19(1):5-14. Disponible en: http://doi.org/10.1002/ejp.522. Epub: 2014 May 13. PMID: 24824334.
Burke D, Fullen BM, Stokes D, Lennon O. Neuropathic pain prevalence following spinal cord injury: A systematic review and meta-analysis. Eur J Pain. 2017;21(1):29-44. Disponible en: http://doi.org/10.1002/ejp.905. Epub: 2016 Jun 24. PMID: 27341614.
Burke D, Lennon O, Fullen BM. Quality of life after spinal cord injury: The impact of pain. Eur J Pain. 2018;22(9):1662-1672. Disponible en: http://doi.org/10.1002/ejp.1248. Epub: 2018 Jun 25. PMID: 29770520.
Frank AO, Spyridonis F, Ghinea G. Assessing pain intensity following spinal cord injury: should rating scales measure 'overall' or 'maximal' values? Int J Rehabil Res. 2015;38(1):92-94. Disponible en: http://doi.org/10.1097/MRR.0000000000000093. PMID: 25419691.
Hunt C, Moman R, Peterson A, Wilson R, Covington S, Mustafa R, et al. Prevalence of chronic pain after spinal cord injury: a systematic review and meta-analysis. Reg Anesth Pain Med. 2021;46(4):328-336. Disponible en: http://doi.org/10.1136/rapm-2020-101960. Epub: 2021 Jan 6. PMID: 33408161.
Finley M, Euiler E, Baehr L, Gracely E, Brownsberger M, Schmidt-Read M, et al. Relationship of psychosocial factors and musculoskeletal pain among individuals with newly acquired spinal cord injury. Spinal Cord Ser Cases. 2021;7(1):a61. Disponible en: http://doi.org/10.1038/s41394-021-00415-4. PMID: 34282128; PMCID: PMC8289908.
Ferrero G, Mijno E, Actis MV, Zampa A, Ratto N, Arpaia A, et al. Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study. Musculoskelet Surg. 2015;99(Suppl 1):S53-S56. Disponible en: http://doi.org/10.1007/s12306-015-0363-2. Epub: 2015 May 23. PMID: 26002597.
Barbetta DC, Lopes AC, Chagas FN, Soares PT, Casaro FM, Poletto MF, et al. Predictors of musculoskeletal pain in the upper extremities of individuals with spinal cord injury. Spinal Cord. 2016;54(2):145-149. Disponible en: http://doi.org/10.1038/sc.2015.126. Epub: 2015 Jul 28. PMID: 26215910.
Gismervik SØ, Drogset JO, Granviken F, Rø M, Leivseth G. Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance. BMC Musculoskelet Disord. 2017;18(1):41. Disponible en: http://doi.org/10.1186/s12891-017-1400-0. PMID: 28122541; PMCID: PMC5267375.
Arnet U, De Vries WH, Eriks-Hoogland I, Wisianowsky C, Van der Woude LHV, Veeger DHEJ, Berger M & for the SwiSCI Study Group. MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain. J Spinal Cord Med. 2022;45(6):916-929. Disponible en: http://doi.org/10.1080/10790268.2021.1881238. Epub: ahead of print. PMID: 33617411.
Shirley Ryan AbilityLab. Rehab Measures Database—Wheelchair User’s Shoulder Pain Index [Internet]. 2014 [actualizado 2014 enero 2; citado 2022 julio 12]. Disponible en: https://www.sralab.org/rehabilitation-measures/wheelchair-users-shoulder-pain-index
Wellisch M, Lovett K, Harrold M, Juhl C, Juul-Kristensen B, McKenna L, et al. Treatment of shoulder pain in people with spinal cord injury who use manual wheelchairs: a systematic review and meta-analysis. Spinal Cord. 2022;60(2):107-114. Disponible en: http://doi.org/10.1038/s41393-021-00673-x. Epub: 2021 Aug 9. PMID: 34373591.
Cratsenberg KA, Deitrick CE, Harrington TK, Kopecky NR, Matthews BD, Ott LM, et al. Effectiveness of Exercise Programs for Management of Shoulder Pain in Manual Wheelchair Users With Spinal Cord Injury. J Neurol Phys Ther. 2015;39(4):197-203. Disponible en: http://doi.org/10.1097/NPT.0000000000000103. PMID: 26308939.
Van Straaten MG, Cloud BA, Zhao KD, Fortune E, Morrow MMB. Maintaining Shoulder Health After Spinal Cord Injury: A Guide to Understanding Treatments for Shoulder Pain. Arch Phys Med Rehabil. 2017;98(5):1061-1063. Disponible en: http://doi.org/10.1016/j.apmr.2016.10.005. Epub: 2017 Feb 7. PMID: 28185640; PMCID: PMC5532812.
Beirens BJH, Bossuyt FM, Arnet U, Van der Woude LHV, De Vries WHK. Shoulder Pain Is Associated With Rate of Rise and Jerk of the Applied Forces During Wheelchair Propulsion in Individuals With Paraplegic Spinal Cord Injury. Arch Phys Med Rehabil. 2021;102(5):856-864. Disponible en: http://doi.org/10.1016/j.apmr.2020.10.114. Epub: 2020 Nov 5. PMID: 33161010.
Lima LV, Abner TSS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. J Physiol. 2017;595(13):4141–4150. Disponible en: https://doi.org/10.1113/jp273355
Nielsen SD, Faaborg PM, Christensen P, Krogh K, Finnerup NB. Chronic abdominal pain in long-term spinal cord injury: a follow-up study. Spinal Cord. 2017;55(3):290-293. Disponible en: http://doi.org/10.1038/sc.2016.124. Epub: 2016 Aug 9. PMID: 27502843.
Coggrave MJ, Ingram RM, Gardner BP, Norton CS. The impact of stoma for bowel management after spinal cord injury. Spinal Cord. 2012;50(11):848-852. Disponible en: http://doi.org/10.1038/sc.2012.66
Chambel SS, Tavares I, Cruz CD. Chronic Pain After Spinal Cord Injury: Is There a Role for Neuron-Immune Dysregulation? Front Physiol. 2020 Jul 7;11:a748. Disponible en: http://doi.org/10.3389/fphys.2020.00748. PMID: 32733271; PMCID: PMC7359877.
Lakra C, Cohen H. A clinical review of the use of Botulinum Toxin type A in managing central neuropathic pain in patients with spinal cord injury. J Spinal Cord Med. 2020;45(5):651-655. Disponible en: http://doi.org/10.1080/10790268.2020.1848278. Epub: ahead of print. PMID: 33263489.
Goetz LL, De Jesus O, McAvoy SM. Posttraumatic Syringomyelia. Treasure Island (Florida, USA): StatPearls Publishing; 2022. PMID: 29262020. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK470405/
Defrin R, Gruener H, Gaidukov E, Bondi M, Rachamim-Katz O, Ringler E, et al. From acute to long-term alterations in pain processing and modulation after spinal cord injury: mechanisms related to chronification of central neuropathic pain. Pain. 2022;163(1):e94-e105. Disponible en: http://doi.org/10.1097/j.pain.0000000000002315. PMID: 33863855.
Vierck C. Mechanisms of Below-Level Pain Following Spinal Cord Injury (SCI). J Pain. 2020;21(3-4):262-280. Disponible en: http://doi.org/10.1016/j.jpain.2019.08.007
Fakhri S, Abbaszadeh F, Jorjani M. On the therapeutic targets and pharmacological treatments for pain relief following spinal cord injury: A mechanistic review. Biomed Pharmacother. 2021;139:111563. Disponible en: http://doi.org/10.1016/j.biopha.2021.111563. Epub: 2021 Apr 16. PMID: 33873146.
Reyes-Campo A, Pacichana-Quinayás SG, Kumar AA, Leiva-Pemberthy LM, Tovar-Sánchez MA, Bonilla-Escobar FJ. Factors associated with neuropathic pain in Colombian patients with spinal cord injury of traumatic origin: case-control study. Spinal Cord Ser Cases. 2022;8:27. Disponible en: http://doi.org/10.1038/s41394-022-00494-x. PMID: 35241659; PMCID: PMC8894347.
Gruener H, Zeilig G, Gaidukov E, Rachamim-Katz O, Ringler E, Blumen N, et al. Biomarkers for predicting central neuropathic pain occurrence and severity after spinal cord injury: results of a long-term longitudinal study. Pain. 2020;161(3):545-556. Disponible en: http://doi.org/10.1097/j.pain.0000000000001740. PMID: 31693542.
Salinas FA, Lugo LH, García HI. Efficacy of early treatment with carbamazepine in prevention of neuropathic pain in patients with spinal cord injury. Am J Phys Med Rehabil. 2012;91(12):1020-1027. Disponible en: http://doi.org/10.1097/PHM.0b013e3182643c85. PMID: 22854901.
Attal N, Bouhassira D, Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. Lancet Neurol, 2018;17(5):456–66. Disponible en: https://doi.org/10.1016/S1474-4422(18)30071-1
Attal N. Spinal cord injury pain. Rev Neurol (Paris). 2021;177(5):606-612. Disponible en: http://doi.org/10.1016/j.neurol.2020.07.003. Epub: 2020 Aug 25. PMID: 32859390.
Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015;2015(9):CD008659. Disponible en: https://doi.org/10.1002/14651858.cd008659.pub3
Loh E, Mirkowski M, Agudelo AR, Allison DJ, Benton B, Bryce TN, et al. The CanPain SCI clinical practice guidelines for rehabilitation management of neuropathic pain after spinal cord injury: 2021 update. Spinal Cord. 2022;60:548-566. Disponible en: http://doi.org/10.1038/s41393-021-00744-z. Epub: ahead of print. PMID: 35124700.
Mei L, Fengqun M, Zhengyao Z, Mingming F, Qing W, Xiaozhuo L, et al. Efficacy and safety of different drug treatments in patients with spinal-cord injury-related neuropathic pain: a network meta-analysis. Spinal Cord. 2022;60:943-953. Disponible en: http://doi.org/10.1038/s41393-022-00804-y. Epub: ahead of print. PMID: 35468995.
Polat CS, Konak HE, Akıncı MG, Onat SS, Altas EU. Misuse of gabapentinoids (pregabalin and gabapentin) in patients with neuropathic pain related to spinal cord injury. J Spinal Cord Med. 2022;Feb 2:1-6. Disponible en: http://doi.org/10.1080/10790268.2021.2024709. Epub: ahead of print. PMID: 35108174.
Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol 2015;14(2):162-173. Disponible en: http://doi.org/10.1016/S1474-4422(14)70251-0. Epub: 2015 Jan 7. PMID: 25575710; PMCID: PMC4493167.
Moisset X, Bouhassira D, Aves Couturier J, Alchaar H, Conradi S, Delmotte MH, et al. Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Rev Neurol (Paris). 2020;176(5):325-352. Disponible en: https://doi.org/10.1016/j.neurol.2020.01.361
Thomas PA, Carter GT, Bombardier CH. A scoping review on the effect of cannabis on pain intensity in people with spinal cord injury. J Spinal Cord Med. 2021;45(5):656-667. Disponible en: http://doi.org/10.1080/10790268.2020.1865709. Epub: ahead of print. PMID: 33465022.
Kumru H, Benito-Penalva J, Kofler M, Vidal J. Analgesic effect of intrathecal baclofen bolus on neuropathic pain in spinal cord injury patients. Brain Res Bull. 2018;140:205-211. Disponible en: http://doi.org/10.1016/j.brainresbull.2018.05.013. Epub: 2018 May 18. PMID: 29782907.
Shaw E, Saulino M. Management Strategies for Spinal Cord Injury Pain Updated for the Twenty-First Century. Phys Med Rehabil Clin N Am. 2020;31(3):369-378. Disponible en: http://doi.org/10.1016/j.pmr.2020.03.004. Epub: 2020 May 22. PMID: 32624100.
Nees TA, Finnerup NB, Blesch A, Weidner N. Neuropathic pain after spinal cord injury: the impact of sensorimotor activity. Pain. 2017;158(3):371–376. Disponible en: http://doi.org/10.1097/j.pain.0000000000000783
Todd KR, Lawrason SVC, Shaw RB, Wirtz D, Martin Ginis KA. Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review. Spinal Cord. 2021;59(2):93-104. Disponible en: http://doi.org/10.1038/s41393-020-00550-z. Epub: 2020 Sep 18. PMID: 32948846.
Jensen MP, Day MA, Miró J. Neuromodulatory treatments for chronic pain: efficacy and mechanisms. Nat Rev Neurol. 2014;10(3):167-178. Disponible en: http://doi.org/10.1038/nrneurol.2014.12. Epub: 2014 Feb 18. PMID: 24535464; PMCID: PMC5652321.
Yang Y, Tang Y, Qin H, Xu J. Efficacy of transcutaneous electrical nerve stimulation in people with pain after spinal cord injury: a meta-analysis. Spinal Cord. 2022;60:375–381. Disponible en: https://doi.org/10.1038/s41393-022-00776-z
Saleh C, Ilia TS, Jaszczuk P, Hund-Georgiadis M, Walter A. Is transcranial magnetic stimulation as treatment for neuropathic pain in patients with spinal cord injury efficient? A systematic review. Neurol Sci. 2022;43(5):3007-3018. Disponible en: http://doi.org/10.1007/s10072-022-05978-0. Epub: 2022 Mar 3. PMID: 35239053.
Quesada C, Pommier B, Fauchon C, Bradley C, Créac'h C, Murat M, et al. New procedure of high-frequency repetitive transcranial magnetic stimulation for central neuropathic pain: A placebo-controlled randomized crossover study. Pain. 2020;161(4):718-728. Disponible en: http://doi.org/10.1097/j.pain.0000000000001760. PMID: 31764387.
Dombovy-Johnson ML, Hunt CL, Morrow MM, Lamer TJ, Pittelkow TP. Current Evidence Lacking to Guide Clinical Practice for Spinal Cord Stimulation in the Treatment of Neuropathic Pain in Spinal Cord Injury: A Review of the Literature and a Proposal for Future Study. Pain Pract. 2020;20(3):325-335. Disponible en: https://doi.org/10.1111/papr.12855. Epub: 2020 Feb 10. PMID: 31691496.
Kaur J, Ghosh S, Sahani AK, Sinha JK. Mental Imagery as a Rehabilitative Therapy for Neuropathic Pain in People With Spinal Cord Injury: A Randomized Controlled Trial. Neurorehabil Neural Repair. 2020;34(11):1038-1049. Disponible en: http://doi.org/10.1177/1545968320962498. Epub: 2020 Oct 10. PMID: 33040678.
Hasan MA, Fraser M, Conway BA, Allan DB, Vučković A. Reversed cortical over-activity during movement imagination following neurofeedback treatment for central neuropathic pain. Clin Neurophysiol. 2016;127(9):3118-3127. Disponible en: http://doi.org/10.1016/j.clinph.2016.06.012. Epub: 2016 Jun 24. PMID: 27472548; PMCID: PMC4988467.
Heutink M, Post MWM, Bongers-Janssen HMH, Dijkstra CA, Snoek GJ, Spijkerman DCM, et al. The CONECSI trial: results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury. Pain. 2012;153(1):12-128. Disponible en: http://dx.doi.org/10.1016/j.pain.2011.09.029.
Eccleston C, Hearn L, Williams AC. Psychological therapies for the management of chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2015;2015(10):CD011259. Disponible en: http://doi.org/10.1002/14651858.CD011259.pub2. PMID: 26513427; PMCID: PMC6485637.
Falci S, Indeck C, Barnkow D. Spinal cord injury below-level neuropathic pain relief with dorsal root entry zone microcoagulation performed caudal to level of complete spinal cord transection. J Neurosurg Spine. 2018;28(6):612-620. Disponible en: http://doi.org/10.3171/2017.9.SPINE17373. Epub: 2018 Mar 2. PMID: 29498583.
Bryce TN, Biering-Sørensen F, Finnerup NB, Cardenas DD, Defrin R, Lundeberg T, et al. International spinal cord injury pain classification: part I. Background and description. Spinal Cord. 2012;50(6):413-417. Disponible en: http://doi.org/10.1038/sc.2011.156. Epub: 2011 Dec 20. PMID: 22182852.
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
