CHRONIC PAIN AFTER SPINAL CORD INJURY:
COMMON CLINICAL PATTERNS
Eva Widerstrom-Noga, PhD, DDS • Robert P. Yezierski, PhD

Chronic pain is frequently reported as a reason for decreased quality of life after SCI. Some people with SCI consider their pain so severe that they would be willing to trade the chance to walk again for pain relief. The challenge in treating chronic pain is understanding the mechanisms that cause pain and designing treatments to “turn them off.” The Miami Project is currently considering steps to initiate clinical trials in spinal cord injured patients suffering from chronic neuropathic pain (see chromaffin cell page.) To diagnose and understand these complex pain conditions, it is important to define common patterns of pain in the experiences of people with SCI. This study sought to analyze the location, quality, intensity, and onset of pain as well as the periods of pain relief experienced following SCI. Of 330 people with SCI who reported chronic pain, 217 agreed to fill out a detailed pain history. Of the respondents, 59.9% reported “burning” pain most commonly located on the front of the torso and genitals, and on the buttocks, thighs, legs and feet. “Aching” pain associated with the neck, shoulders and back was described by 54.4%. While these symptoms are seen in all levels of injury, there is a relationship between the location of pain and the level of spinal cord injury. People with cervical injuries more commonly reported shoulder and neck pain. About 59% reported that their most disturbing pain started within 6 months of their injury. These data and the patterns this postal survey reveals may assist in a better understanding of the mechanisms of pain following SCI and therefore, help in the design of improved treatment strategies.