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The Relationship Between Pain Interference and Psychosocial Well-Being Among Veterans With Spinal Cord
Bella Etingen1, Scott Miskevics, Sherri L LaVela
1Questions or comments about this article may be directed to Bella Etingen, PhD, at bella.etingen@va.gov. She is a Research Health Scientist, Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL. Scott Miskevics, BS, is Data Management Programmer, CINCCH, Health Services Research & Development, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL. Sherri L. LaVela, PhD MPH MBA, is Research Health Scientist, CINCCH, Health Services Research & Development, Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, and Research Assistant Professor, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Objectives:
The study objectives were to compare psychosocial well-being in individuals with spinal cord injuries/disorders (SCI/D) and above-mean ("high") versus below-mean ("low") pain interference, and to determine whether psychosocial well-being was negatively associated with pain interference.
Methods:
Data were collected via a cross-sectional survey mailed in late 2014 to early 2015 to a national sample of veterans with SCI/D who received prior-year Veterans Affairs healthcare and assessed demographics, injury-related factors, select health conditions, pain interference, and psychosocial well-being. Bivariate comparisons and multivariate linear regressions identified factors related to higher pain interference.
Results:
Approximately 79% of the sample (n = 813) reported high pain interference. Veterans with high (vs. low) pain interference reported worse perceptions of all included psychosocial well-being measures. Regression results indicated that higher pain interference was associated with higher grief/loss (β = 0.38, P < .0001) and negative psychosocial illness impact (β = 0.39, P < .0001), and lower positive affect (β = -0.39, P < .0001), resilience (β = -0.31, P < .0001), and life satisfaction (β = -0.39, P < .0001).
Conclusions:
The pain experience is independently associated with poor psychosocial well-being among individuals with SCI/D. Efforts to decrease perceptions of pain interference and improve factors associated with psychosocial well-being may symbiotically improve outcomes in SCI/D cohorts. Such efforts may focus on effective pain management programs aligned with patients' treatment preferences.
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