Pain in patients with spinal cord injury: a review

Chronic pain after spinal cord injury is a highly prevalent clinical condition, which is difficult to treat. Therefore, it is important to know its clinical characteristics and causes for a better diagnostic and therapeutic approach. The objective of this study was to review the literature on pain in patients with spinal cord injury and the possible association with physical (level of the injury, completeness of lesion, pain duration) and psychological (mood and quality of life) factors.

Original studies in the Medline database with patients older than 18 years and published over the last six years were reviewed. The clinical characteristics of pain in patients with spinal cord injury are discussed, and the works of several authors are compared.

Despite conceptual and methodological differences among the studies, the prevalence of pain in patients with spinal cord injury was high, varying from 64% to 82%. Neuropathic pain at the level of the injury has an early onset (days or weeks), while that below the level of the injury has a late onset (months or years). An association between pain and integrity of the lesion is not observed, and the percentage of patients who complain of severe pain varies from 21% to 39%. It was not possible to conclude which is the relationship between pain and level of spinal cord injury. However, pain can have a negative influence on mood and in the capacity to perform cognitive, social, recreational, and work-related activities.