Central pain caused by spinal cord injury
Damage to the spinal cord from trauma or demyelinating lesions is known to cause central pain. In fact, 10% to 49% of patients may develop chronic pain following acute SCI. There is significant variation in clinical presentation of central pain caused by SCI. Patients may have spontaneous or evoked dysesthesias with or without associated paresthesias, described as tingling, numbness, or squeezing. Painful areas may be small or large, unilateral or bilateral, and stable or fluctuating in size and location. Flexor or extensor spasms, which may be spontaneous or precipitated by movement or distention of the bladder or bowel, can contribute significantly to pain. The pain may be at level of the lesion (also known as transitional zone pain) or “below level,” primarily impacting the more distal body. Some patients have secondary musculoskeletal pain including of the trunk, shoulders, or limbs that often has different characteristics and responds to different treatments than the neuropathic SCI pain.
