Consumer Perspectives on a Multimodal Approach to Make Neuropathic Pain Manageable After SCI
Abstract
Up to 80% of individuals develop chronic pain within their first year after a spinal cord injury (SCI). Persistent neuropathic pain negatively influences quality of life and independent living after SCI by interfering with sleep, mood, and physical and social activities. Because treatment approaches focusing exclusively on pharmacological treatments have limited effectiveness in reducing the intensity and impact of SCI-related neuropathic pain, optimal pain management strategies need to incorporate multiple ways to reduce pain. A multimodal patient-centered approach to managing pain after SCI should be guided by consumers expectations and perspectives. Recent recommendations for the treatment of neuropathic pain after SCI strongly suggest treatments that combine pharmacological and non-pharmacological interventions for optimal pain management. The proposed project is directly based on our previous DOD-funded studies showing that SCI consumers with neuropathic pain want better information about their treatment options and pain itself and better access to non-pharmacological options. Therefore, the underlying idea of this proposal is to facilitate and fast-track the development of effective clinical SCI neuropathic pain trials and programs that are tailored to consumers preferences, underlying mechanisms and predictors of manageable pain. Some SCI consumers perspectives on education and non-pharmacological treatments: Pain is something that an individual has to educate themselves on how to tolerate, and they can only educate themselves if the material is presented or if they re allowed access to educational materials in regards to how to cope with their pain. Knowledge is power, the more you know about whatever s going on with your body and the more you understand your body, the better the decisions you re going to be able to make Meeting other people who had injuries, you hear about other things but you don t have access to a lot of things that might be helpful… The study will examine consumers perspectives on a 10-week pain program that combines pain education with two safe non-pharmacological approaches. For SCI consumers to provide critical viewpoints on the program, they must experience it firsthand. Therefore, 35 participants with SCI who experience moderate to severe neuropathic pain will evaluate the pros and cons of a non-pharmacological approach based on pain education, upper body exercise, and visual illusion that targets multiple mechanisms of the pain experience. Neuropathic pain types, associated psychosocial factors, and the effects of a visual illusion will be evaluated, and their relationship with manageable pain and impression of change will be examined. The study is expected to significantly and rapidly influence future clinical pain trials and clinical care for those with SCI who experience neuropathic pain. Because the proposed pain program will be evaluated by SCI consumers, it will ensure that the program leads to clinical trial designs that are relevant for consumers. One of the advantages of our non-pharmacological approaches is that people who are taking pain medication can continue to do so if they wish, or it will provide an opportunity to reduce pain medication. The approaches proposed are associated with no risk to minimal risk, and the proposed study will help us better understand the meaning of manageable pain and global impression of change and the relationship with neuropathic pain and underlying mechanisms.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110497
Entities
People
- Eva Widerstrom-noga
Organizations
- United States Army
- University of Miami