Pain in a Swedish spinal cord injury population

Budh, Cecilia Norrbrink; Lund, Irène; Ertzgaard, Per; Holtz, Anders; Hultling, Claes; Levi, Richard; Werhagen, Lars; Lundeberg, Thomas

doi:10.1191/0269215503cr664oa

Cited by 67 publications

(64 citation statements)

References 10 publications

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“…For example, chronic pain is one of the most frequently recorded reasons for reduced QOL following SCI and may have more impact on QOL scores than the extent of damage associated with SCI. [14][15][16][17] Pain severity was one of the few factors that predicted well-being in a large study of 1668 persons with tetraplegia. 18 However, an Australian survey which examined QOL for both SCI and those with traumatic brain injuries did not identify pain as one of the 10 key issues affecting QOL.…”

Section: Introductionmentioning

confidence: 99%

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

et al. 2007

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Study Design: Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL). Setting: Australia. Methods: A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients' subjective evaluation of pre-and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time. Results: A significant difference was found between perception of pre-and postmorbid function on composite Cognitive (t ¼ 5.99, df ¼ 62, Po0.001), Physical (t ¼ 11.56, df ¼ 62, Po0.001), and QOL (t ¼ 7.16, df ¼ 62, Po0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (Po0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2 ¼ 0.20, Po0.001); emotional (R 2 ¼ 0.13, Po0.004); and of QOL (R 2 ¼ 0.22, Po0.001) functioning. With the exception of a decrease in happiness (Po0.01), there were no significant changes in any measures over the 6 month time period. Conclusions: There are significant changes in patients' perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys.

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Section: Introductionmentioning

confidence: 99%

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

et al. 2007

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“…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.…”

Section: Introductionmentioning

confidence: 72%

“…Prevalence of pain in the non-matched population consisting of 456 individuals In this study 10 456 patients were assessed regarding perception of pain and its prevalence. Gender di erences were found signi®cant in the analysis of pain prevalence.…”

Section: Resultsmentioning

confidence: 99%

“…12 Several studies have described pain prevalence, risk-factors, pain and medical variables and psychosocial scores in SCI populations, 2 ± 6,8 ± 12 but since results vary from study to study there is no consensus. 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).…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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Gender related differences in pain in spinal cord injured individuals

et al. 2003

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Study design: Out of a population of 456 patients with spinal cord injuries (SCI), 130 having pain were selected after matching, based on gender, age, American Spinal Injury Association (ASIA) impairment grade and level of lesion. Objective: To investigate whether gender di erences with regard to pain perception and prevalence exist in a population of patients following spinal cord injury. Setting: Spinalis SCI Unit (out-patient clinic), Stockholm, Sweden. Method: 130 patients su ering from pain were assessed over a 12-month period in a yearly health control. Results: SCI women had a higher prevalence of nociceptive pain than men and their use of analgesics was greater. However, no di erences between the sexes could be seen regarding pain and localization, onset, distribution, factors a ecting pain, number of painful body regions, pain descriptors, ratings of pain intensities or in pain and life satisfaction. Conclusion: This study showed that SCI men and women describe their pain very similarly. However, SCI women had a higher prevalence of nociceptive pain than men and their use of opiates and non-steroid anti-in¯ammatory drugs (NSAIDs) was greater.

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Neuropathic pain prevalence following spinal cord injury: A systematic review and meta‐analysis

Burke

Fullen

Stokes

et al. 2016

European Journal of Pain

293

168

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Following spinal cord injury (SCI), chronic pain is a common secondary complication with neuropathic pain (NP) cited as one of the most distressing and debilitating conditions leading to poor quality of life, depression and sleep disturbances. Neuropathic pain presenting at or below the level of injury is largely refractory to current pharmacological and physical treatments. No consensus on the prevalence of NP post SCI currently exists, hence this systematic review was undertaken. The review comprised three phases: a methodological assessment of databases [PubMed, Embase, Web of Knowledge, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and Physiotherapy Evidence Database (PEDro)] identifying potential papers and screening for inclusion criteria by two independent reviewers; data extraction; and finally rating of internal validity and strength of the evidence, using a published valid and reliable scale. Meta-analysis estimated pooled point prevalence rates using a random effects model. In total, 17 studies involving 2529 patients were included in the review. Overall point prevalence rates for NP were established at 53% (38.58-67.47); 19% (13.26-26.39) for at-level NP and 27% (19.89-34.61) for below-level NP, with high heterogeneity noted (I 2 = 84-93%). Prevalence rates for NP following SCI are high. Future studies should include established definitions, classification systems and assessment tools for NP at defined time points post SCI to follow the trajectory of this problem across the lifespan and include indices of sleep, mood and interference to allow for appropriate, optimal and timely NP management for each patient. What does this review add?: This is the first systematic review and meta-analysis to record pooled point prevalence of neuropathic pain post spinal cord injury at 53%. Additional pooled analysis shows that neuropathic pain is more common below the level of lesion, in patients with tetraplegia, older patients and at 1 year post injury.

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Pain in a Swedish spinal cord injury population

Abstract: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.

Cited by 67 publications

References 10 publications

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

Gender related differences in pain in spinal cord injured individuals

Neuropathic pain prevalence following spinal cord injury: A systematic review and meta‐analysis

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