Volume 44 Number 5 2007
Pages 703 — 716

Abstract - Chronic pain after spinal cord injury: What characteristics make some pains more disturbing than others?

Elizabeth Roy Felix, PhD;1-2* Yenisel Cruz-Almeida, MSPH;1-3 Eva G . Widerström-Noga, DDS, PhD1-4

1Research Service, Department of Veterans Affairs Medical Center, Miami, FL; 2The Miami Project to Cure Paralysis, 3Neuroscience Program, and 4Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL

Abstract — Different types of pain are often present in the same individual with spinal cord injury (SCI). Relieving the most disturbing of these pains may substantially affect quality of life. Persons with SCI and chronic pain (n = 194) completed a structured interview that detailed the characteristics of each pain they experienced. Pairwise analyses revealed that the following characteristics were more common among the most disturbing pains: "sharp"; "stabbing"; located at the level of injury; frequently aggravated; and having high intensity, unpleasantness, constancy, interference, and neuropathic pain-like features. A conditional logistic regression analysis showed that the combination of "sharp" and high pain intensity, interference, aggravation, and constancy significantly predicted the most disturbing pain (p < 0.001). This study suggests that, in addition to pain intensity, factors such as interference, quality, aggravation, and constancy of pain are important to consider when one evaluates SCI-related pain, since these symptoms may indicate pains that are particularly disturbing to an individual with SCI.

Key words: chronic pain, intractable pain, neuropathic pain, numerical rating scale, pain descriptors, pain interference, quality of life, rehabilitation, spinal cord injury, structured interview.

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