Spinal cord injury pain classification: History, current trends, and commentary

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Pain following spinal cord injury (SCI) has been well described in the literature over the years, but both SCI pain research and clinical care have been hampered by the lack of a uniform method for assessing pain. There have been a large number of proposed classification systems published, but no consensus to date on what criteria are required for each subtype of pain or the procedures to be used to make that determination. Accordingly, the literature is filled with descriptions of clinical series and some controlled trials of the treatment of SCI pain with no clear idea as to what percentage of the sample experienced neuropathic pain, musculoskeletal pain, or both. The more recent literature has been more specific with trials directed at specific subtypes of SCI pain. In this article, we review the history of SCI classification schemes, describe current efforts to develop a unified classification scheme and an accompanying set of diagnostic procedures, and describe international efforts along these lines. We also describe translational work related to SCI pain and the benefits and shortcomings of current animal models of SCI pain. Finally, several of the authors provide comments on the direction they think the field needs to take to continue to move this line of inquiry further.

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