Review Article

Guidelines for chronic pain in adult spinal cord injury population: Scoping review

Tammy-Lee Williams, Conran Joseph, Lena Nilsson-Wikmar, Joliana Phillips
South African Journal of Physiotherapy | Vol 80, No 1 | a1931 | DOI: https://doi.org/10.4102/sajp.v80i1.1931 | © 2024 Tammy-Lee Williams, Conran Joseph, Lena Nilsson-Wikmar, Joliana Phillips | This work is licensed under CC Attribution 4.0
Submitted: 15 June 2023 | Published: 06 May 2024

About the author(s)

Tammy-Lee Williams, Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
Conran Joseph, Division of Physiotherapy, Faculty of Health and Rehabilitation Services, Stellenbosch University, Stellenbosch, South Africa; and Department of Neurobiology, Faculty of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Lena Nilsson-Wikmar, Department of Neurobiology, Faculty of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Joliana Phillips, Department of Research Development and Postgraduate Support, Faculty of Research and Innovation, University of the Western Cape, Cape Town, South Africa

Abstract

Background: Chronic pain among survivors of spinal cord injury (SCI) hurts physical and mental health. Persons with SCI have demonstrated dissatisfaction with the management of their chronic pain.

Objectives: This study aimed to identify existing clinical practice guidelines for chronic pain in the SCI population.

Method: A scoping review was conducted across various databases available at the University of the Western Cape, in addition to guideline clearing houses (BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline [EbscoHost], Medline [Pubmed], Sabinet Reference, SAGE Journals Online, ScienceDirect, SCOPUS, Wiley Online Library, Springerlink, PubMed, Guideline Central, and Agency for Healthcare Research and Quality). The population consisted of adults with SCI, and the interventions that were included were pharmacological and nonpharmacological management of chronic pain. Guidelines that met the inclusion criteria were critically appraised by two reviewers from this study using the AGREE II instrument. Inter-rater reliability was calculated using SPSS 27, and Cohen’s kappa coefficients were established.

Results: Five articles were included in the data extraction, analysis and appraisal. Two guidelines were rated as high quality, according to the AGREE II tool. In addition, most guidelines focused on neuropathic pain (NeuP) and only one guideline included nociceptive pain and NeuP.

Conclusion: One guideline met the objectives of this scoping review.

Clinical implications: Guidelines developed in the future should include a screening tool to identify the specific type of pain and distinguish peripheral NeuP from central NeuP.


Keywords

chronic pain; traumatic spinal cord injury; clinical practice guidelines; pharmacological management; nonpharmacological management

Sustainable Development Goal

Goal 3: Good health and well-being

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