Freda Warner’s PhD Thesis Proposal

Title: “The effects of early pain management on neurological recovery following acute spinal cord injury”

Supervisor: Dr. John Kramer (Kinesiology)
Committee Members: Dr. Tania Lam (Kinesiology), Dr. Helen Tremlett (SPPH), Dr. David Whitehurst (SFU)

Abstract: For individuals with spinal cord injury (SCI), parts of the body that were once connected to the brain become isolated, leading to diminished movement (paralysis), reduced sensation, and various secondary conditions. Presenting in the initial days to weeks after injury, pain represents a particularly debilitating consequence of SCI, significantly affecting quality of life. Unfortunately, both neuropathic and nociceptive (musculoskeletal) pain are refractory to many treatment options, and necessitate lifelong management.

While the relief of pain symptoms after SCI is of the utmost importance, it may also be important to consider the long-term impacts of pain and acutely administered pain medications on neurological outcomes (e.g. recovery) following injury. Based on preclinical animal models, the neuromodulatory properties of pain by almost every major class of pain medication, including antidepressants, anticonvulsants, non-steroidal anti-inflammatories (NSAIDs), and opioids, has been reported. However, the effects of pain and acute pain management on sensory and motor recovery after SCI have not been examined in humans. I therefore will examine whether pain and pain medications are inadvertently changing the course of recovery following SCI.