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Spinal Cord (2016) 54, S7S13Ofcial Journal of the International Spinal Cord Society
http://www.nature.com/sc
Web End =www.nature.com/sc
GUIDELINES
The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations
S Mehta1,2, SD Guy1,2, TN Bryce3, BC Craven4, NB Finnerup5, SL Hitzig4, S Orenczuk7, PJ Siddall8,E Widerstrm-Noga9, A Casalino7, I Ct6, D Harvey10, A Kras-Dupuis7, B Lau11, JW Middleton8,DE Moulin2,12, C OConnell13, AG Parrent2,14, P Potter7, C Short15, R Teasell1,2,7, A Townson11, C Truchon16, D Wolfe1,2,7, CL Bradbury4 and E Loh1,2,7
Study design: Clinical practice guidelines.
Objectives: To develop the rst Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI).
Setting: The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada.
Methods: The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Results: Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. Conclusions: The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.
Spinal Cord (2016) 54, S7S13; doi:http://dx.doi.org/10.1038/sc.2016.89
Web End =10.1038/sc.2016.89
INTRODUCTIONAn international panel of expertsthe CanPainSCI Working Group (WG)was formed to develop the rst Canadian clinical practice guidelines (CPGs) to inform the management of at- and below-level neuropathic pain (NP) after spinal cord injury (SCI) in an inpatient and outpatient rehabilitation setting. Using a consensus-based, modied Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, recommendations have been made for three specic areas of management: screening and diagnosis, treatment and model of care.1 This paper focuses on the screening and diagnosis of NP.
Challenges in identifying and classifying pain in SCIDiagnosing NP is a complex task requiring a combination of clinical skill and experience, validated assessment tools and relevant investigations, as a range of individual and environmental factors are implicated in the development of NP.2 In addition, despite the recognized high prevalence of pain post...