Central neuropathic pain: implications on quality of life of spinal cord injury patients

Abstract

BACKGROUND AND OBJECTIVES: Pain is one consequence of spinal cord injury, added to micturition and intestinal disorders, changes in sexuality and reproduction, and social and family issues. Understanding pain and its interference with quality of life may help professionals assisting patients to find the most adequate way to control neuropathic pain. Investigators of the International Association for the Study of Pain have evaluated articles from 1975 to 2007 and have observed that the least studied subject was spinal cord pain. This study aimed at evaluating quality of life of patients with neuropathic pain induced by traumatic spinal cord injury. METHODS: This is a quantitative, transversal, exploratory and descriptive research. RESULTS: Seventy percent of patients with neuropathic pain classify it as severe to intense, with scores above five in the visual analog scale. Males, aged between 30 and 39 years, married, with injury by fall, paraplegic, with incomplete injury and injury time between one and five years are those most suffering with pain. Quality of life is better for patients with complete spinal cord injury and who were wounded by firearm. Patients with fecal incontinence have referred worse quality of life and also stated that pain impaired their lives. CONCLUSION: It was observed that patients referring more severe pain have worse quality of life and social relations, which address personal relations, sexual life and support from friends.

Prevalence and Characteristics of Neuropathic Pain in Patients With Spinal Cord Injury Referred to a Rehabilitation Center

“…In terms of demographics, the only significant relationship identified in this study was between marital status and NP prevalence. Rita et al reported that pain intensity among married patients was higher than that among single patients with traumatic SCI [ 31 ]. In one study, a univariate analysis of a cohort of patients with traumatic SCI found that married patients reported more pain interference 2 years post-injury than single patients [ 28 ].…”

Quality of life in patients with tetraplegia and paraplegia after traumatic spinal cord injury

“…Sexual functions are a very important factor in the QOL; recovery of these activities is the highest priority in patients with paraplegia and is in second place of priority in the tetraplegic patients after recovery of hand function [31,32]. Numerous studies have shown that sexual life is one of lower-graded components of the WHOQOL-BREF scale [33][34][35], with lower scores compared to the general population [36]. Anderson et al [37] attempted to answer the question of whether improvement of sexual function might significantly improve the QOL.…”

Intervenção da Terapia Ocupacional no desempenho ocupacional na sexualidade de pessoas com lesão medular: relato de caso

“…Com relação ao domínio dor houve melhora nos escores. A dor pode exercer um papel bastante negativo, não só no desempenho da sexualidade, como no desempenho ocupacional geral (Aquarone, Faro & Nogueira, 2015). A atividade física, como o fortalecimento, libera endorfina, potente analgésico endógeno que reduz a dor e o estresse e, além disso, aumenta a produção de serotonina.…”

“…Em condições normais, as atividades sexuais seguem um processo natural, controlado pelo Sistema Nervoso Central que envia as mensagens à medula espinhal, provocando reações no sistema autônomo (como a ereção) (Aquarone, Faro & Nogueira, 2015). Para que essas reações aconteçam, os neurotransmissores dopaminérgicos são disparados na fenda sináptica, despolarizando a membrana, sendo considerado um potencial de ação excitatório do sistema nervoso.…”