Pain prevalence and its determinants after spinal cord injury: A systematic review

Abstract

Pain prevalence studies are important as they illustrate the magnitude of pain problems in a certain patient population, such as patients living with a spinal cord injury (SCI). Strikingly, reported pain prevalence rates in SCI patients are found to vary greatly, while determinants for the differences between pain prevalence reports remain unclear. We here aim to identify determinants for the differences (heterogeneity) in pain prevalence reports through a systematic review of all SCI pain prevalence reporting studies. Literature search was done using Medline, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge and Embase. Data abstraction was performed while blinded and was followed by meta-(regression)-analyses. We identified 82 studies. Study design-related determinants of SCI pain prevalence reports were pain definition strictness (mild, moderate or high), primary study goal (pain study or not), data source (retrospective or not), and in a limited number of cases response/attrition rates. While correcting for these items, population characteristics correlating with pain prevalence rates were both proportion of patients with a depression and average time after injury (positive correlations). Between-study heterogeneity may remain even after the identification/correction of above-mentioned causes of heterogeneity.Pain after SCI does seem to relate to the duration of the injury and depression, yet major causes of bias in reported pain prevalence are found to be related to the primary study goal (pain study or not), choice of pain definition and the use of retrospective data.

Assessments of sensory plasticity after spinal cord injury across species

“…Sensory dysfunction is of major clinical relevance, as the majority of SCI patients report some pain [15] and NP occurs in over 50% of patients with a SCI [16–18]. Understanding how outcome measures of sensory plasticity change during recovery is essential for cross-species translation, especially when translating novel treatments emerging from preclinical research into the clinical setting [19].…”

Psychosocial aspects of spinal cord injury pain: a meta-analysis

“…musculoskeletal, visceral) pain of varying intensity, quality and constancy. [1][2][3] For many, this results in a pain continuum, from acute biomedical treatment through to management of persistent pain. 4,5 SCI pain management is further complicated by a multitude of cognitive, emotional, behavioural and social factors that can adversely affect, or buffer, the pain experience.…”

Promoting Gait Recovery and Limiting Neuropathic Pain After Spinal Cord Injury

“…49 Did the other 10 studies also include individuals with pain? Considering that pain is reported to affect one half to two thirds of persons with SCI, 1 it is very likely that these studies included individuals with one or more types of pain. Indeed, 2 studies hinted toward the inclusion of individuals with pain by reporting gabapentin use (a drug prescribed for neuropathic pain management) 56 or having lost a patient at follow-up due to increased knee and low back pain.…”