Pain following spinal cord injury: result from a postal survey

Rose, Melanie J.; Robinson, J.; Ells, P.; Cole, Jonathan

doi:10.1016/0304-3959(88)90187-x

Cited by 80 publications

(6 citation statements)

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“…Pain is a major problem among patients with SCI, imposing several limitations to the patients. A previous study in England reported that 11% of patients with SCI consider pain rather than mobility disorder as a deterrent in their daily activities [ 18 ]. Another study reported 37% of patients with high level lesions and 23% of patients with low level lesions were willing to exchange loss of reacquired physiologic functions for pain relief [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Pain and Its Effect on Quality of Life and Functioning in Men with Spinal Cord Injury

et al. 2015

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BackgroundPain is one of the most important consequences of spinal cord injury (SCI). It may affect several aspects of life, especially the quality of life (QoL). Hence, this study was conducted to establish an understanding of pain and its correlates and effects on patients with SCI in our community.MethodsIn a cross-sectional study, 58 male veterans suffering from SCI were admitted to our center for a regular follow-up. Demographic and SCI-related descriptive information were gathered using a self-reported questionnaire. To evaluate the patients' pain quality and the effect of pain on daily life, a questionnaire in 3 parts of lumbar, cervical and shoulder pain was administered. EuroQoL questionnaire and General Health Questionnaire (GHQ) 12 were also used to assess the patients' QoL.ResultsThe mean age of the participants was 45.91 ± 6.69 with mean injury time of 25.54 ± 5.91. forty-four patients (75.9%) reported pain, including lumbar pain (63%), cervical pain (39%) and shoulder pain (51%). The presence of pain was associated with lower QoL. Patients with lumbar pain reported a significant amount of pain affecting their daily life and this effect was higher in patients with lower GHQ score or anxiety/depressive disorder.ConclusionsMusculoskeletal pain, is a common complaint in veterans with SCI and is inversely associated with functioning and general health status. Lumbar and shoulder pain affects patient's daily living more than cervical pain.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Pain and Its Effect on Quality of Life and Functioning in Men with Spinal Cord Injury

et al. 2015

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“…Chronic pain may complicate spinal cord injury in as many as 60% of cases [49] and is usually difficult to manage. For a thorough account of assessment and management of this problem, the reader is directed to the chapter by Glynn and Teddy [50].…”

Section: Pathophysiologymentioning

confidence: 99%

Anaesthesia for chronic spinal cord lesions

1998

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SummaryIncreasing numbers of patients with spinal cord injury present for surgery or obstetric care. Spinal cord injury causes unique pathophysiological changes. The most important peri-operative dangers are autonomic dysreflexia, bradycardia, hypotension, respiratory inadequacy and muscle spasms. Autonomic dysreflexia is suggested by headache, sweating, bradycardia and severe hypertension and may be precipitated by surgery, especially bladder distension. Patients with low, complete lesions, undergoing surgery below the level of injury, may safely do so without anaesthesia provided there is no history of autonomic dysreflexia or troublesome spasms. An anaesthetist should be present to monitor the patient in this situation. General anaesthesia of sufficient depth is effective at controlling spasms and autonomic dysreflexia but hypotension and respiratory dysfunction are risks. There is a growing consensus that spinal anaesthesia is safe, effective and technically simple to perform in this group of patients. We present a survey of 515 consecutive anaesthetics in cord-injured patients and a review of the current literature on anaesthesia for patients with chronic spinal cord lesions. Dramatic improvements in the care of spinal cord injury patients have been achieved over the last few decades [1]. The active management of urinary tract and respiratory complications has lead to a decrease in mortality from renal and respiratory failure. Overall mortality decreased from over 80% at the time of World War I to less than 2% by the early 1980s. The implications of increased survival are an increase in the prevalence of spinal cord injuries, an increase in the numbers of patients presenting for elective surgery and an ever increasing number of spinal cord injured patients who develop further medical conditions as the result of normal ageing.Although the majority of spinal cord injured patients currently undergo elective surgery in specialised spinal units, the appearance of such patients on operating lists of other hospitals is likely to increase. Anaesthesia in the cord-injured patient poses unique difficulties. An understanding of the relevant pathophysiology assists in the provision of safe peri-operative care.

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“…El baclofeno, agonista GABA, tiene el riesgo de producir hiperespasticidad de rebote con su retirada, y su uso perioperatorio no presenta interacciones anestésicas relevantes. Debe tenerse en cuenta que hasta el 60% de los pacientes con LMC presentan dolor crónico tanto neuropático como nociceptivo y su manejo es complicado 9 . La retirada de tratamiento neuropático en el perioperatorio presenta el riesgo de desencadenar un empeoramiento del dolor, si bien el mantenimiento de fármacos como la amitriptilina supone un riesgo proarritmogénico, y el mantenimiento de la duloxetina tiene el riesgo de producir un síndrome serotoninérgico.…”

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