CHRONIC PAIN IN THE SPINAL-CORD INJURED - STATISTICAL APPROACH AND PHARMACOLOGICAL TREATMENT

We include in this article the results of a postal inquiry into chroni c pain in SCI patients in Valencia (Spain), and our experience with th eir management. A mailed questionaire including lesion and chronic pai n data was sent to all of the 380 SCI patients who live in the region of Valencia. We received 202 answers, with 145 questionaires being acc urately answered and these were analysed for this study. The results s how that chronic pain (that is, lasting more than 6 months) is very co mmon (65.5.%). The most frequent type was deafferentation pain (phanto m pain), described as burning or a painful numbness. Since 1988 we hav e been treating a sample of 33 patients suffering from resistant pain according to the following therapies: 1 amitryptiline + clonazepan + N SAID (nonsteroidal antiinflammatory drugs); 2 amitryptiline + clonazep an + 5-OH-tryptophane + TENS (transcutaneous electrical nerve stimulat ion); 3 amitryptiline + clonazepan + SCS (spinal cord stimulation); 4 morphine, by continuous intrathecal infusion. After almost 4 years usi ng these therapies we can affirm that the results regarding analgesia reached 80% in all cases, and that morphine used by intrathecal route is very safe and useful in selected patients.