Exercise-based interventions for pain management in individuals with spinal cord injury: A scoping review.

CONTEXT: spinal cord injury (SCI) can cause significant pain through its effects on nociceptive and neuropathic pathways, reducing quality of life. Various forms of exercise-based rehabilitation have been developed; however, findings from previous studies examining their effectiveness remain inconsistent across different pain types in individuals with SCI. OBJECTIVE: The primary aim of this scoping review was to map the available evidence on exercise-based interventions used for pain management in individuals with SCI and identify existing research gaps. METHODS: A literature search was conducted across MEDLINE, Embase, Scopus, and Web of Science for studies published from January 2000 to December 2025. Studies involving adults with SCI experiencing pain who participated in structured exercise programs were included. Data were extracted and descriptively synthesized by pain type and exercise modality. RESULTS: Exercise therapies, including strengthening, aerobic training, functional electrical stimulation (FES), robotic or locomotor training, and mind-body approaches, were examined. Several studies reported favorable outcomes for movement-based interventions in reducing shoulder pain. However, findings related to aerobic exercise for general or neuropathic pain were mixed. Although emerging approaches such as virtual reality and mind-body therapies have been explored, the overall evidence remains limited and inconsistent, indicating that more rigorous research is necessary to determine their effectiveness in pain management. CONCLUSION: Current evidence indicates that exercise-based interventions have been most frequently investigated for musculoskeletal shoulder pain, while evidence addressing neuropathic pain remains limited. High-quality studies with standardized methodologies are needed.