Pain during in-patient rehabilitation after traumatic spinal cord injury

Abstract

In this prospective study, we surveyed the pain experience of 40 participants during the in-patient rehabilitation period following traumatic spinal cord injury (SCI). Twenty-eight patients (70% of the study population) had musculoskeletal (MS) pain or neuropathic (NP) pain. Pain responded positively to physical therapy and analgesics. A numerical pain scale decreased from a mean of 6.36+/-1.7 on admission to 3.2+/-1.94 on discharge (P<0.001). Paraplegic patients were more likely to have MS pain (P=0.001) and NP pain (P=0.046). There was no relationship between completeness of injury, or spinal surgery, and type of pain encountered. There was also no significant difference in the modified Barthel index between patients with and without pain on admission and discharge. We conclude that pain is a common experience in SCI patients and that it can be reduced significantly by the end of in-patient rehabilitation.

Neuropathic Pain in Patients with Spinal Cord Injury

“…Werhagen et al found no statistically significant difference in neuropathic pain prevalence between tetraplegic and paraplegic patients and those with complete and incomplete lesions [19]. Other studies suggest no significant relationship between the level of injury and the presence of pain and pain severity [20,21]. When the groups with or without pain were compared, we found no Several studies have reported that the most important factor preventing daily living activities in patients with SCI is pain [19,22,23].…”

Upper limb assessment in tetraplegia

“…Some important clinical aspects, such as spasticity (Tsao and Mirbagheri, 2007) and pain (Yap et al, 2003;Jensen et al, 2007) that could influence upper limb function and motor strategies, were not assessed in this study, but it should be explored in future researches.…”

Measuring Pain in Persons with Spinal Cord Injury

“…15 The NRS has also been shown to be sensitive to meaningful decreases in pain 16 and to changes in pain associated with treatment, such as inpatient rehabilitation. 17 Construct validity for the NRS has been established through association with negative outcomes, such as interference with basic activities of daily living, poorer psychological functioning, 18,19 self-reported difficulty in "dealing with pain," and sleep disruption 8 in persons with SCI. Consistent with these data, NRS ratings of severity have been shown to predict treatment seeking.…”