Pain Relief for the Spinal Cord

Spinal cord injury (SCI) describes traumatic damage to the spinal cord, which extends from the brain through the center of the bones (vertebrae) of the neck and back. Damage may be the result of direct impact upon the cord itself, or injury to the adjoining tissue, blood vessels or bone. Treatment for pain associated with SCI is typically tailored to the needs of each person affected.

Understanding Spinal Cord Pain

• According to the University of Alabama at Birmingham's Spinal Cord Injury Information Network, pain associated with SCI comes in three main forms. Neuropathic pain results from damage to your nervous system, which typically manifests as a shooting, sharp or burning sensation. Musculoskeletal pain results from instability in your vertebrae, muscular overuse or muscles spasms. It is commonly characterized as a dull, aching sensation. Visceral pain is a constant burning or cramping sensation in your abdomen either above or below the site of your injury. Frequently, different types of SCI-related pain appear simultaneously. Be aware that you may have pain in parts of your body where full sensation is still available to you, as well as in areas that produce little or no normal sensation.

Devising a Treatment Program

• Relief from SCI pain typically involves a combination of medications and modified physical activities. Either of these approaches may also be used as a separate therapy. Be aware that your doctor may initially have some difficulty in sorting out the sources of your SCI pain. Before treating you, he will question you at length to learn as much about your particular symptoms as possible. He will then use this information to help design a customized treatment program.

Treatment Options

• In most cases, neuropathic pain is the hardest to address. Medications commonly used for this purpose include amitriptyline, nortriptyline and gabapentin (Neurontin). Your doctor may also choose to implant a pump under your skin that delivers controlled doses of clonidine or an opiate medication. Other treatment options for neuropathic pain include epidural blocks and the implantation of a spinal cord stimulator.

  If you have pain related to muscular overuse, your doctor or physical therapist may work with you to modify potentially harmful activities. Potential steps include scheduling your days in advance and adhering to pre-set time limitations for stressful actions. Pain from instability in your vertebrae can also be addressed through appropriate activity limitations, although in some cases your condition may require treatment with nonsteroidal anti-inflammatory (NSAID) medications, opiates or surgery. If you suffer from muscle spasm pain, your doctor can prescribe medications such as baclofen or diazepam (Valium).

  Visceral pain has a number of potential causes, and your doctor will adapt his treatment recommendations to your particular situation. For example, if your pain is related to nerve damage, you will likely receive neuropathic pain medications or opiates. If your pain is related to organ damage, you may be treated through modifications of your bowel and bladder activity, or through surgery. Consult your doctor for additional information on potential treatment approaches.