Individuals With Prior Chronic Pain and Long-Term Opioid Treatment May Experience Persistence of That Pain Even After Subsequent Complete Cervical Spinal Cord Injury: Suggestions From a Prospective Case-Controlled Study.
Jeffrey S Hecht, Kyle L Johnson Moore, Roy F Roberts
PMID 39006114WHAT IT FOUND
Four of seven patients with complete cervical spinal cord injury reported that their pre-existing chronic pain persisted unchanged despite total loss of sensation below the injury.
All four had prior long-term opioid use. The three patients without persistent pain had no such history.
Key findings
01Four of seven patients reported continued chronic pain after complete cervical SCI, while three did not.
02All four patients with persistent pain had prior long-term opioid therapy, whereas none of the three without persistent pain had such history.
03Patients with persistent pain described the quality, location, and severity as identical to their pre-injury state.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample size was only seven patients, preventing any meaningful statistical analysis. The diagnosis of complete SCI relied on clinical examination rather than objective neurophysiological tests, leaving open the possibility of 'discomplete' injuries with residual nerve function. There were other differences between the two groups, such as duration of pain and social stability, which could be confounding factors. Long-term outcomes were not available for all patients due to death or lack of follow-up.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the association between prior opioid use and persistent pain as proof that opioids cause pain to persist in the brain. The study is a case series of seven people with no control group for statistical comparison, and it cannot rule out other factors like pain severity or social stability that differed between the groups.