The Problem of Pain After a Spinal Cord Injury

Pain can be an issue for people with spinal cord injuries and it’s an area of care that needs proper management. It can affect the individual in locations where sensation has been reduced (or even lost completely) as a result of the damage to the spinal cord, as well as parts of the body that have not been directly impacted by the injury.

Pain for those with a spinal cord injury (SCI) can be chronic and it can impact the individual’s ability to carry out daily activities, affecting both their physical and mental health.

Here we take a closer look at the different kinds of pain that may be experienced following an injury to the spinal cord and how it can be managed effectively in the short and long-term. The good news is that there are many different treatments and approaches available nowadays.

Different Types of Pain Following a Spinal Cord Injury

Pain will vary from individual to individual and will be dependent on the severity and level of the spinal cord injury that has been sustained.

The brain send signals to other parts of the body via the spinal cord, allowing movements to be made. This biological system, the nervous system, also transmits messages to the brain related to how pain is felt. Neuropathic or neurogenic pain is where the nerves send misleading messages to the brain – suggesting that the individual is experiencing pain when they are actually not.

Those with spinal cord injury pain may experience stabbing, burning or tingling sensations and the severity and location can vary a great deal from person to person.

Musculoskeletal pain comes from real injuries and strains that occur to areas like the muscles, joints and bones. Someone with a spinal cord injury, for example, may suffer from pain in the shoulders or neck after using a manual wheelchair and overstraining themselves.

People with paraplegia and tetraplegia may often experience back and neck pain. If someone regularly suffers from spasticity (where muscles contract suddenly), then this can cause pain in the area affected because of the pressure put on the muscles.

Visceral pain may also occur. This can be complicated to diagnose as the pain can happen because of a problem elsewhere in the body. For example, gall bladder issues can cause shoulder pain.

Pain Management After a Spinal Cord Injury

Pain after a spinal cord injury should be managed carefully and this can take a number of different forms. It usually involves assessing the individual and coming up with a personal pain management solution that fits their own specific needs.

Physical interventions may include:

• Using physical therapy such as stretching muscles to alleviate pain from cramping or strains.
• Changing assistive equipment such as cushions, beds or wheelchairs to better support the individual.
• Using exercise as a way to build up muscle strength and improve joint flexibility.
• Therapeutic massage may help some individuals with spinal cord injury pain to find relief.
• Low levels of electrical stimulation to certain muscle groups can also have a therapeutic effect.  

Medical interventions include:

• Taking simple anti-inflammatory drugs such as ibuprofen and aspirin.
• Various anti-seizure drugs such as Neurontin and some antidepressants also help treat neuropathic pain.
• Opiates such as morphine and codeine may be used in more severe cases of chronic pain, though usually for limited time periods.
• Anti-spasticity medicines and drugs that relax the muscles can be used to treat pain caused by spasms.
• Topical anesthetics such as creams can be used to treat localized, surface pain.

Psychological interventions include:

• Relaxation and biofeedback techniques to reduce the perception of pain.
• Psychotherapy and restructuring how people think about pain.

Surgical interventions include:

• Inserting a spinal cord stimulator for pain management.
• Surgical placement of an intrathecal pump under the skin to deliver pain or spasm relief.

Useful Tips For Dealing with Pain

Managing pain is a very personal thing. Tips for keeping control and reducing the impact of spinal cord injury pain include:

• Making sure an individual seeks medical treatment if there is a problem.
• Maintaining as healthy a lifestyle as possible, including exercising regularly and eating properly.
• Treating issues such as depression which can make pain feel worse.
• Reducing stress which can make it harder to cope with pain, often by using relaxation techniques.
• Getting an evaluation of assistive equipment such as a wheelchair to see if changes can improve comfort levels.
• Not using alcohol to help ease any chronic pain.
• Keeping a pain diary to understand how it affects an individual’s life and what interventions work better.

A Common Symptom

Unfortunately, chronic pain in spinal cord injuries is a common symptom and one that should be managed effectively. The good news is that there are plenty of different approaches to alleviating chronic pain but finding what works for the individual is important.