Chronic pain after spinal cord injury: What characteristics make some pains more disturbing than others?

Abstract

Abstract-Different types of pain are often present in the same individual with spinal cord injury (SCI). Relieving the most disturbing of these pains may substantially affect quality of life. Persons with SCI and chronic pain (n = 194) completed a structured interview that detailed the characteristics of each pain they experienced. Pairwise analyses revealed that the following characteristics were more common among the most disturbing pains: "sharp"; "stabbing"; located at the level of injury; frequently aggravated; and having high intensity, unpleasantness, constancy, interference, and neuropathic painlike features. A conditional logistic regression analysis showed that the combination of "sharp" and high pain intensity, interference, aggravation, and constancy significantly predicted the most disturbing pain (p < 0.001). This study suggests that, in addition to pain intensity, factors such as interference, quality, aggravation, and constancy of pain are important to consider when one evaluates SCI-related pain, since these symptoms may indicate pains that are particularly disturbing to an individual with SCI.

The International Spinal Cord Injury Pain Basic Data Set

“…First, most people with SCI experience three or fewer pain problems. 12 Second, describing the details of more than three different simultaneous pain problems may induce errors in the data collection due to increased assessment burden. Although the intent of the ISCIPDS:B is to evaluate each separate pain problem, it may also be used to evaluate the only most significant or 'worst' pain problem if there are severe time constraints.…”

An interactive 3-D application for pain management: Results from a pilot study in spinal cord injury rehabilitation

“…Although loss of function is the main consequence of SCI, the symptoms experienced from the presence of such chronic pain could be so severe that it has been reported to frequently interfere with sleep and everyday activities [3]. To this end, approximately 37% of SCI patients reported that they would like to be relieved from this burden even if they had to trade it with additional loss of bladder, bowel, or sexual function [2].…”

2D vs. 3D Pain Visualization: User Preferences in a Spinal Cord Injury Cohort

“…Due to their established usefulness and acceptance in assessing pain across various medical conditions [8,11,12], there have also been efforts to utilise the benefits of pain drawings to the SCI population that is characterised by the severity of this injury, which appears, for instance, in approximately more than 1,000 people per year in Britain alone [17]. To this end, [15] have used pain drawings to assess back pain and spinal deformity, whereas [4] attempted to identify and relieve the most disturbing pains in patients with a SCI that affect the quality of their life. Similarly, [5] utilised pain drawings before and after surgery to evaluate treatment interventions in SCIs.…”

“…Reports from individuals who have suffered this kind of trauma reveal that the severity of such pain experience could be so immense that it often interferes with sleep and everyday activities [4]. In fact, a summary of results from several studies [see 16,19] indicates that the average reported estimate of the prevalence of chronic SCI pain is approximately 65%, with roughly one-third of those affected reporting the severity as greater than 7 in a scale of 10 on a Visual Analogue Scale (VAS).…”