Neuropathic Pain: A Secondary Complication of Spinal Cord Injury

Defining and understanding pain has been considered a challenge among medical professionals because of the subjectivity and difficulty to assess pain experiences among patients. Literature associated with pain uses both a broad (i.e., referring to dysfunction) and narrow (i.e., referring to lesion) definition to describe neuropathic pain. The broad definition of pain includes various conditions, such as complex regional pain syndromes or even musculoskeletal disorders with signs of hypersensitivity which may be regarded as neuropathic pain (Cruccu et al., 2004). Traditionally, it was common to include other types of pain experiences within the description of “neuropathic” pain (Siddall & Cousins, 1998). The International Association for the Study of Pain (IASP) defined neuropathic pain as “pain initiated or caused by a primary lesion or dysfunction of the nervous system” (Merskey & Bogduk, 1994, p.212). A narrow and more specific definition of neuropathic pain notes that when the principal abrasion is located in the central nervous system, it is referred to as central neuropathic pain, and when the abrasion is located in the peripheral nervous system it is labeled as peripheral neuropathic pain (Siddall & Cousins, 1998). However, it is not uncommon for most conditions to become centralized. Other definitions that follow a narrow approach indicate: neuropathic pain is the result of an injury or condition affecting the somatosensory system (i.e., pain, temperature, touch, and proprioception) (Di Stefano et al., 2012); or, the result of abnormal processes of the nervous system and persists past the standard period of tissue healing (Eide, 1998; Mann, 2008).