Joel A. DeLisa

Clinical Evaluation The Physical Examination Electrodiagnostic Evaluation of the Peripheral Nervous System Central Nervous System Electrophysiology Assessment of Human Muscle Function Human Walking Disability Determination Imaging Techniques Relative to Rehabilitation Functional Neuroimaging in Medical Rehabilitation Populations Interactions with the Medicolegal System Therapeutic Physical Agents Biofeedback in Physical Medicine and Rehabilitation Manipulation, Massage and Traction Injection Procedures The Pharmacology of Analgesic Agents Spinal Injection Procedures Therapeutic Exercise Electrotherapy in Rehabilitation Complementary and Alternative Medicine Aquatic Rehabilitation Treatment of the Patient with Chronic Pain Palliative Care Sports Medicine Recreation and Sport for Persons with Disabilities Arts Medicine Cumulative Trauma Disorders Disorders of the Cervical Spine Low Back Pain Scoliosis 30 Osteoporosis Rehabilitation of the Patient with Inflammatory Arthritis and Connective Tissue Disease Osteoarthritis Peripheral Vascular Diseases Rehabilitation of Persons with Parkinson's Disease and Other Movement Disorders Upper Extremity Soft Tissues Injuries Hand Disorders Rehabilitation After Lower Limb Joint Reconstruction Foot Disorders/Shoes Peripheral Neuropathy Myopathy Motor Neuron Disease Vestibular Rehabilitation Functional Evaluation and Management of Self Care and Other Activities of Daily Living Psychological Aspects of Rehabilitation Speech, Language, Swallowing and Auditory Rehabilitation Rehabilitation Team Function and Prescriptions, Referrals, and Order Writing Vocational Rehabilitation, Independent Living and Consumerism Ethical Issues in Rehabilitation Medicine The International Classification of Functioning, Disability, and Health: ICF Empowering Rehabilitation Through an Operational Bio-Psycho-Social Model Research in Physical Medicine and Rehabilitation Administration and Management in Physical Medicine and Rehabilitation International Aspects of Rehabilitation Principles and Applications of Measurement Methods Systematically Assessing and Improving the Quality and Outcomes of Medical Rehabilitation Programs Measuring Quality of Life in Rehabilitation Medicine Pharmacotherapy of Disability Medical Emergencies Nutrition in Physical Medicine and Rehabilitation Wheelchairs Assistive Technology Upper and Lower Extremity Prosthetics Spinal Orthotics Upper Extremity Orthotics Lower Extremity Orthotics, Shoes and Gait Aids Gait Restoration and Gait Aids Functional Neuromuscular Stimulation Spasticity and Movement Disorders Immobility and Inactivity Physiological and Functional Changes Prevention and Treatment Primary Care for Persons with Disabilities Children with Disabilities Congenital and Childhood Onset Disabilities: Age Related Changes and Secondary Conditions in Mobility Impairments Geriatric Rehabilitation Health Issues for Women with Disabilities Sexuality and Disability Pressure Ulcers

BACKGROUND: Neuropathic pain is a common complaint after traumatic spinal cord injury (SCI). Gabapentin, a synthetic structural analogue of GABA, has been shown to have beneficial effects in the treatment of neuropathic pain in other diagnostic groups; however, no standardized clinical trial has been performed to evaluate its efficacy after SCI. DESIGN: A 10-week, prospective, randomized, double-blind, crossover, and placebo-controlled clinical trial. OBJECTIVE: To determine the efficacy of gabapentin in the treatment of SCI-related neuropathic pain. METHODS: Seven subjects with neuropathic pain, who were more than 30 days post-SCI, completed the study. Two groups received a 4-week course of gabapentin and placebo in a randomized crossover design with a 2-week washout period. The Neuropathic Pain Scale was used to record daily pain levels. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Gabapentin has some beneficial effects on certain types of neuropathic pain. There was a significant decrease of "unpleasant feeling" and a trend toward a decrease in both the "pain intensity" and "burning sensation" at the fourth week of gabapentin treatment compared with those on the placebo. No significant difference was found among other pain descriptors during the gabapentin and placebo treatment, although this may have been limited by the small sample size and low maximum dosage of gabapentin. CONCLUSIONS: Gabapentin reduces certain types of neuropathic pain in the SCI population. Future studies with larger sample sizes, higher dosages, and quicker titration will help further determine the efficacy of gabapentin in the treatment of SCI-related neuropathic pain.