Effectiveness of Non-pharmacological and Non-surgical Interventions to Support Pain Management after Spinal Cord Injury

Chronic pain estimates for people with spinal cord injuries (SCI) vary. Pain is mostly managed pharmacologically. Yet, many patients are dissatisfied with the way their pain is managed. This systematic review explores the role and effectiveness of non-pharmacological and non-surgical interventions for pain in people with SCI. Four electronic databases, including Medline, Embase, Cinahl, PsycInfo were systematically searched for the period 1996–2009. Thirteen papers met the inclusion criteria and interventions comprised acupuncture, exercise, transcranial electromagnetic stimulation and hypnosis/relaxation. Study quality generally was poor to average. Most studies, albeit originating from one center focused on exercise. Strongest findings exist for transcranial stimulation resulting from two well-conducted and documented double blinded randomized controlled trials. However, the active intervention was in both trials not significantly more effective to reduce pain than sham interventions. More high quality studies are needed to explore how non-pharmacological and non-surgical interventions can effectively complement current pain management. The role of rehabilitaton professionals in supporting pain self management also needs further attention.