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Case Reports in Medicine
Volume 2015 (2015), Article ID 764950, 3 pages
http://dx.doi.org/10.1155/2015/764950
Case Report

Walking with Neuropathic Pain: Paradoxical Shift from Burden to Support?

1Institute for Neuropathic Pain, Vespuccistraat 64-III, 1056 SN Amsterdam, Netherlands
2Institute for Neuropathic Pain, Spoorlaan 2a, 3735 MV Bosch en Duin, Netherlands
3Habilita, Care & Research Rehabilitation Hospitals, Via Bologna 1, 24040 Zingonia, Italy

Received 11 June 2015; Accepted 15 July 2015

Academic Editor: A. Curt

Copyright © 2015 David J. Kopsky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Baclofen 5% cream can be used for the treatment of neuropathic pain. We describe an unusual case of a neuropathic pain patient with spinal cord injury. A 71-year-old woman with a partial spinal cord injury lesion at L4 complained of tingling, pins and needles, and burning in her legs. She scored her pain as 6 before adding baclofen 5% cream to her pain medication (pregabalin 450 mg, acetaminophen 3000 mg, and diclofenac 150 mg daily). One month later she experienced complete pain relief, though experienced increased difficulties in walking, leading to frequent falls. Her steadier walking without stumbling and falling was more important to her than pain reduction. Thus she decided to stop using baclofen. This unusual case report discusses two important issues that relate to pain medicine and rehabilitation in patients with painful spinal cord lesions: (1) the presence of wide areas of sensory loss “covered” by the presence of painful sensations and (2) pathological sensations that can be used and integrated in the body schema to create an improved spatiovisual orientation and thus mobility. Both these aspects have to be taken into account when treating pain and design rehabilitation programs.