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Location and Quality of SCI Pain

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Widerstrom-Noga et al. (2001) conducted a careful analysis of the relationship between the location of the pain and the patients’ description of the pain. In this study 217 of 330 patients reporting chronic pain in a previous survey agreed to participate in the study. Participants had been injured for an average of 8.2±5.1 years and 55.4% were quadriplegic. Most subjects in this study marked multiple areas on a pain drawing with the back area being most frequently implicated (61.8%). 59.9% complained of a burning pain while 54.9% described an aching pain. Interestingly burning pain was significantly associated with pain localized to the front of the torso and genitals, buttocks and lower extremities. In contrast, aching type pain was significantly associated with pain localized to the neck, shoulders and back.

Widerstrom-Noga et al. (2001) noted that the descriptor “burning” is often associated with neuropathic pain (Fenollosa et al. 1993; Ragnarsson 1997; Siddall et al. 1999) whereas “aching” is often associated with musculoskeletal pain (Siddall et al. 1999; Tunks 1986). However, since there is a significant overlap in the quality of pain types it is difficult to establish a definitive clinical relationship (Bowsher 1996; Eide 1998; Widerstrom-Noga et al. 2001). Widerstrom-Noga et al. (2001) suggest that musculoskeletal-type pain (best characterized by the aching pain in the neck, shoulders and back) is potentially amenable to therapeutic interventions and aggressive attempts should be made to ameliorate this type of pain. All of this underscores the need for a reproducible classification system of the pain experienced following SCI. Bennett et al. (2007) have noted that the increasing reliance on validated screening tools may help “form the basis of forthcoming clinical diagnostic criteria”.

Conclusion

The most common types of pain post SCI are: 1) a burning pain (likely neuropathic) usually localized to the front of torso, buttock or legs or 2) an aching pain (likely musculoskeletal) usually localized to the neck, shoulders and back.

  • Post-SCI pain is most commonly divided into neuropathic or musculoskeletal pain.