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Chapter 1 - Central Neuropathic Pain Signaling Pathways

from Part I - Introduction to Pain: Pain Signaling Pathways

Published online by Cambridge University Press:  01 December 2023

Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Neuropathic pain (NP) is a common complication of spinal cord injury (SCI) that is difficult to treat. Chronic NP is associated with increased levels of inflammatory mediators and ion channel dysfunction, as well as nerve damage and nerve-glia crosstalk. Recent studies have made headway in identifying novel biomarkers, including microRNA and psycho-social attributes that can predict progress from SCI to chronic NP (CNP). Conventional medical treatment has limited success, but recent studies have identified new biomarkers and promising drugs, such as baclofen and ziconotide, that can provide pain relief. However, further studies are needed to determine the safety profile of these drugs. Nonmedical interventions, such as brain sensitization and biofeedback techniques, have also shown promise in managing CNP. A multidisciplinary approach, including psycho-social support, medical and nonmedical interventions, is necessary to effectively manage CNP in SCI patients.

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Publisher: Cambridge University Press
Print publication year: 2023

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