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2�C5 In particular, SCI-associated NeP has been shown to be associated with a substantial socioeconomic burden, with higher health care resource utilization and costs and lower health status and productivity observed at increasing levels of pain.6 Almost all patients with SCI have the potential to engage in functional activities; thus, improvement in function is a key goal of patients post injury and a major focus of Vandetanib SCI rehabilitation, which takes an integrated approach to the management of these patients. However, in addition to the reductions in function and quality of life noted earlier, the presence of pain negatively affects inpatient rehabilitation therapy: fewer days in rehabilitation and less rehabilitation treatment time were reported among patients with the highest pain severity levels relative to those with no pain and lower pain levels.7 When pain is present, a core element of SCI management is pain reduction to a level that the patient considers acceptable, as complete relief is rarely possible. A variety of pharmacologic interventions are available for SCI pain, and those especially used for NeP include antidepressants, antiepileptic drugs, opioids, and various intrathecal medications.8�C10 While several medications have been studied in NeP associated with SCI, most of these studies utilized a small sample (��40 subjects) and a short-treatment duration (��4weeks).11 Currently, only Itraconazole pregabalin has received US Food and Drug Administration approval in the US for treatment of NeP associated with SCI.12 Approval in SCI-related NeP was based on two clinical trials in which pregabalin resulted in significantly greater pain reductions relative to placebo (Pcheck details in functional outcomes, and a recent meta-analysis of gabapentinoids further supported its efficacy for pain and secondary outcomes in patients with NeP associated with SCI.16 With regard to function, moderate-to-strong correlations have been observed between pain intensity and interference with daily activities using various versions of the Brief Pain Inventory (BPI); higher levels of pain intensity consistently resulted in greater interference.3,4 Given these observed associations, it may be expected that relief of NeP resulting from treatment would result in functional improvements. However, such an association between levels of pain reduction and functional improvement in patients with SCI has not been evaluated.
