Movement imagery increases pain in people with neuropathic pain following complete thoracic spinal cord injury.

Full Abstract

Spinal cord injury (SCI) results in deafferentation and the onset of neuropathic pain in a substantial proportion of people. Based on evidence suggesting motor cortex activation results in attenuation of neuropathic pain, we sought to determine whether neuropathic SCI pain could be modified by imagined movements of the foot. Fifteen subjects with a complete thoracic SCI (7 with below-level neuropathic pain and 8 without pain) were instructed in the use of movement imagery. Movement imagery was practiced three times daily for 7days. On the eighth day, subjects performed the movement imagery in the laboratory and recorded pain ratings during the period of imagined movement. Six out of 7 subjects with neuropathic pain reported an increase in pain during imagined movements from 2.9+/-0.7 during baseline to 5.0+/-1.0 during movement imagery (p<0.01). In SCI subjects without neuropathic pain, movement imagery evoked an increase in non-painful sensation intensity from a baseline of 1.9+/-0.7 to 4.8+/-1.3 during the movement imagery (p<0.01). Two subjects without a history of pain or non-painful phantom sensations had onset of dysesthesia while performing imagined movements. This study reports exacerbation of pain in response to imagined movements and it contrasts with reports of pain reduction in people with peripheral neuropathic pain. The potential mechanisms underlying this sensory enhancement with movement imagery are discussed.

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Author information

Author/s: Gustin, Sylvia M (SM); Wrigley, Paul J (PJ); Gandevia, Simon C (SC); Middleton, James W (JW); Henderson, Luke A (LA); Siddall, Philip J (PJ);

Affiliation: Department of Anatomy and Histology, F13, The University of Sydney, Sydney, NSW 2006, Australia.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Pain (Pain), published in Netherlands. (Language: eng)

Reference: 2008-Jul; vol 137 (issue 2) : pp 237-44

Dates: Created 2008/06/30; Completed 2008/09/18;

PMID: 17942228, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Humans
Imagery (Psychotherapy) - methods
Imagination - physiology
Male
Middle Aged
Motor Cortex - physiology

Movement - physiology
Pain, Intractable - physiopathology; psychology; therapy
Peripheral Nervous System Diseases - physiopathology; psychology; therapy
Phantom Limb - physiopathology; psychology; therapy
Spinal Cord - physiopathology
Spinal Cord Injuries - complications; physiopathology
Thoracic Vertebrae
Treatment Failure

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