Classification of Post-SCI Pain

Describe a classification system for pain related to SCI?
1. Post-SCI pain can most commonly be divided into neuropathic (figure 7 and 8) or musculoskeletal pain.
2. The IASP Classification of Post-SCI Pain is shown in table 2.

Table 2. Proposed IASP Classification of Pain Related to SCI.

Broad Type

(Tier 1)

Broad System

(Tier 2)

Specific Structure/Pathology (Tier 3)



Bone, joint, muscle trauma, or inflammation

Mechanical instability

Muscle spasm

Secondary overuse syndromes


Renal calculus, bowel, sphincter dysfunction, etc.

Dysreflexic headache


Above Level

Compressive mononeuropathies

Complex regional pain syndromes

At Level

Nerve root compression (including cauda equina)


Spinal cord trauma/ischemia (transitional zone, etc.)

Dual-level cord and root trauma (double lesion syndrome)

Below Level

Spinal cord trauma/ischemia (central dysesthesia syndrome, etc.)

*This article was published in Physical Medicine and Rehabilitation Clinics of North America, 18, Ullrich, Pain Following Spinal Cord Injury, 217-233, Copyright Elsevier (2007).

For more information please see: Classification of Post-SCI Pain.

Figure 7. In neuropathic pain a damaged nerve (shown in yellow) may send wrong messages to the brain. This can result in the brain indicating on-going distress when this is no longer the case.  

Figure 8. The development of a belt-like zone of hypersensitivity across injured T8-9 roots. Below level there is dense anesthesia and paralysis, with burning leg pain.