Central pain of cord origin is also known as below-level pain, remote pain, functionally limiting dysesthetic pain syndrome. Burning dysesthetic pain and central dysesthesia syndrome are general terms that have been used to describe CCP too.

Lesions causing CCP (Tables 3.1 and 3.2)

CP has been reported with virtually every type of disease or lesion affecting the spinal cord substance (dorsal horns), be it a complete or an incomplete lesion. Trauma/concussion (civilian gunshot wounds and automobile accidents in western countries) is the leading cause of CCP worlwide, but iatrogenic lesions dismayingly follow suit. CP, although only one of the many chronic pains observed after SCI (Table 3.3), is by far the most severe and disabling, and in many patients may limit their functional ability and daily activities.

Incidence and prevalence (Table 3.4)

Literature series are not comparable, because pain terms used are not homogeneous and research methods vary widely (e.g. subjective self-reports versus objective study); moreover, CCP can be “simulated” by other concurrent pains, making it difficult to tease out, and in most series there is no agreement on what “true CP” is. Thus, quoted estimates of CCP in the literature range from a few to almost all. Burke (1973) even reported different incidences of pain among paraplegics in different societies, which he blamed on some aspects of patient management.