Chronic Pain Secondary to Disability: A Review

Ehde, Dawn M.; Jensen, Mark P.; Engel, Joyce M.; Turner, Judith A.; Hoffman, Amy J.; Cardenas, Diana D.

doi:10.1097/00002508-200301000-00002

Cited by 181 publications

(132 citation statements)

References 105 publications

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“…20 Researchers commonly note relationships between pain and fatigue following SCI yet rarely acknowledge that although pharmacological attempts to relieve pain after SCI are not demonstrably effective, 23 they may significantly increase fatigue. 7 Moreover, by considering the impact of fatigue solely on self-care activities, for example 3,24 researchers have often overlooked its impact on those activities most closely associated with quality of life: engagement in family, social, recreational and productive activities.…”

Section: Discussionmentioning

confidence: 99%

“…A literature review of the nature and treatment of pain following SCI noted the striking deficiency of knowledge about effective treatments for addressing pain, 23 despite considerable research interest in this area. The claim that fatigue in SCI may be prevented by fighting physical deconditioning 5 fails to address the multifactorial influences on fatigue in SCI (Table 2).…”

Section: Discussionmentioning

confidence: 99%

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Fatigue and spinal cord injury: a qualitative analysis

et al. 2008

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Objectives: To explore experiences of fatigue among people with spinal cord injuries (SCIs) and factors perceived to contribute to fatigue. Setting: Kelowna, Prince George, Vancouver and Victoria, British Columbia, Canada. Study design: Collaborative, qualitative methodology. Methods: Four focus groups were undertaken simultaneously with a total of 29 participants, comprising a purposive sample of men and women: 21 people with complete and incomplete SCI of high and low tetraplegia and paraplegia, 2 family members, 2 assistants and 4 occupational therapists. Interpretive analysis was grounded in the themes identified in the data. Results: Fatigue was perceived to have cognitive, emotional and physical dimensions and to exert a profound effect on the lives of many people with SCI, such that pleasurable activities were often eschewed to enable the accomplishment of more mundane tasks. Factors most consistently associated with fatigue were pain, depression and hopelessness, side effects of medications, poor quality sleep, spasticity, poor posture, diet, and the effort required to accomplish routine and self-care tasks. Conclusions: Fatigue is a complex phenomenon, interlinked with pain, depression and hopelessness that significantly diminishes the quality of life following SCI. Further research is required to provide greater understanding of this issue and to determine appropriate and comprehensive forms of intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatigue and spinal cord injury: a qualitative analysis

et al. 2008

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“…The prevalence of pain after SCI has been reported as 11-94% of the patients. 3 Although the pain often starts within the initial 6 months of SCI, it frequently persists and sometimes can even become aggravated over time. 4 As pain is known to affect recreational activities and vocational status, 5 quality of sleep 6 and sexuality, 7 it can have a major role in QoL, mood and rehabilitation outcome.…”

Section: Introductionmentioning

confidence: 99%

Effects of chronic pain on quality of life and depression in patients with spinal cord injury

Ataoglu¹,

Tiftik²,

Kara³

et al. 2012

Spinal Cord

124

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esign: A cross-sectional study. Objective: To assess the effects of pain on quality of life (QoL), functional independence and depression in patients with spinal cord injury (SCI). Setting: An inpatient rehabilitation center. Methods:A total of 140 patients (104 M, 36 F) with SCI who underwent inpatient rehabilitation treatment were examined. A questionnaire including clinical variables was applied. Motor score of Functional Independence Measure was used to assess dailylife activities, the 36-Item Medical Outcomes Short-Form Health (SF-36) for QoL and Beck Depression Inventory (BDI) for depression. Patients were then divided into those having chronic pain (Group I) and those without any pain (Group II), and groups were compared according to demographic and clinical variables. Results: The most common causes of SCI were falls (35.0%) and motor vehicle accidents (34.2%). Chronic pain was present in 78% of patients. Patients employed before injury and patients who had complete injury had lower Numerical Rating Scale scores (Po0.05). SCI patients with chronic pain had higher depression ratings and their BDI scores were correlated with some of the SF-36 domains (general health, vitality, social functioning and mental health). Only bodily pain and social functioning (Po0.05) scores were found to be lower in Group I (Po0.05) when compared with Group II. Conclusion: As mood and QoL are negatively affected with pain in SCI patients, we suggest that chronic pain should always be treated in a multidisciplinary setting where pharmacological, physical and psychological therapies are combined.

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“…The greater use of analgesics could be justifi ed by the frequent occurrence of pain among persons with a physical disability. 9,19 Studies on the use of analgesics in the general population show different values, according to the country and methodology adopted. In Brazil, use of analgesics was reported by 22% of respondents in a national survey conducted in 2003.…”

Section: Discussionmentioning

confidence: 99%