Comparing chronic pain from spinal cord injury to chronic pain of other origins

Abstract

Acknowledged as a serious complaint of spinal cord injured (SCI) patients, chronic pain in this population is neither well studied nor well understood. To assess the quality and intensity of pain, a group of 49 SCI patients seeking treatment for chronic pain was compared to a general group of 95 patients from the Comprehensive Pain Clinic (CPC) on selected demographic variables, the McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI). The SCI patients were categorized as functionally incomplete SCI (SCI-I) or complete SCI (SCI-C). Multivariate analyses revealed differences among groups on the MPQ for Number of Words Checked, Rank Sum, and the Affective dimension. In all cases the CPC group scored higher than the SCI-C group. The MMPI profiles were elevated and typical for the CPC and SCI-C groups and substantially less elevated for the SCI-I group. We suggest in cases where chronic pain is secondary to a chronic medical catastrophe, aspects of the MPQ and the MMPI assess the person's total medical disability and not just the meaning and impact of pain.

Factors associated with acute and chronic pain following traumatic spinal cord injuries

“…Some researchers believe that it has a minor impact, 2 whilst others argue that its impact is signi®cant. 3,4 Britell and Mariano (1991) summarised the spinal cord injury pain literature and found that the prevalence of pain ranged from 27 ± 77%, providing evidence that it is a major problem and that it should not be neglected.…”

The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: introduction, methodology and recommendation overview

“…[1][2][3][4][5][6][7] Pain negatively interferes with sleep, return to work, health-related quality of life and participation in social activities. 3 In addition, pain is associated with poorer rehabilitation outcomes and directly contributes to disability.…”

“…1 NP is common, with the prevalence of below-level pain after SCI reported as 34% and at-level pain reported as 42%. 2 Specifically within Canada, NP after SCI is the most common complication reported by 1549 people with SCI. 3 Despite the high frequency of pain in those with SCI and its significant impact on quality of life, management of pain remains challenging.…”

Gender related differences in pain in spinal cord injured individuals

“…Pain seems to have an early onset after the injury, 2 ± 4,6,10 is reported mainly from below or at the level of the lesion, 2,5,6,10 and is mostly classi®ed as neurogenic/neuropathic. 1,10,13 (The term neurogenic will be used throughout this paper). According to Ravenscroft and colleagues 4 a higher incidence of pain is seen in patients with complete injuries.…”

“…However, others have reported a higher incidence in those with incomplete lesions 6,8,10 and this has been supported by autopsy ®ndings, 14 further supported by the ®nding that patients with incomplete lesions have more severe pain than those with complete lesions. 13 Age has previously been reported to in¯uence the vulnerability to pain. 15,16 StoÈ rmer 2 found a signi®cant di erence between age at injury and the presence of pain in SCI patients.…”