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.