Spinothalamic tract (STT) dysfunction seems to be crucially involved in the development of central neuropathic pain (NP) after spinal cord injury (SCI). However, previous attempts to identify differences in the extent or location of STT damage between subjects with and without NP failed. Here we show that the spontaneous recovery of human STT function (within the first year after SCI) in subjects suffering NP is enhanced compared to those not affected. Furthermore, the correlation between current pain intensity (assessed on average 5 years after SCI) and extent of functional recovery substantiates the close relationship between recovery of STT function and the occurrence of NP. These findings contribute to a better understanding of mechanisms involved in the generation of NP after SCI.