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Pain Research and Treatment
Volume 2012 (2012), Article ID 840486, 13 pages
http://dx.doi.org/10.1155/2012/840486
Review Article

Combination Drug Therapy for Pain following Chronic Spinal Cord Injury

The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 SW 14th Terrace, Miami, FL 33136, USA

Received 29 November 2011; Accepted 6 January 2012

Academic Editor: Carlo Luca Romanò

Copyright © 2012 Aldric Hama and Jacqueline Sagen. 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

A number of mechanisms have been elucidated that maintain neuropathic pain due to spinal cord injury (SCI). While target-based therapeutics are being developed based on elucidation of these mechanisms, treatment for neuropathic SCI pain has not been entirely satisfactory due in part to the significant convergence of neurological and inflammatory processes that maintain the neuropathic pain state. Thus, a combination drug treatment strategy, wherein several pain-related mechanism are simultaneously engaged, could be more efficacious than treatment against individual mechanisms alone. Also, by engaging several targets at once, it may be possible to reduce the doses of the individual drugs, thereby minimizing the potential for adverse side effects. Positive preclinical and clinical studies have demonstrated improved efficacy of combination drug treatment over single drug treatment in neuropathic pain of peripheral origin, and perhaps such combinations could be utilized for neuropathic SCI pain. At the same time, there are mechanisms that distinguish SCI from peripheral neuropathic pain, so novel combination therapies will be needed.