Impact on Quality of Life
It is estimated that 30-40% of patients with SCI experience severe disabling pain (Burke & Woodward 1976). Pain is often reported as the most important factor for decreased quality of life. Nepomuceno et al. (1979) noted that 23% of individuals with cervical or high thoracic SCI and 37% of those with low thoracic or lumbosacral injury would trade the loss of sexual and/or bowel and bladder function as well as hypothetical possibility for cure to obtain pain relief.
Rose et al. (1988) sent a questionnaire to 1,091 spinal cord injured individuals. Pain, which was reported as constant in 43%, was considered severe at some point in the day in half the sample and mild to moderate in 21% of respondents. Prior to the SCI, 595 of the sample were employed; afterwards only 325 were employed. Interestingly 98 SCI individuals (11%) reported it was the severity of their pain and not their paralysis, which stopped them from working. Of the 325 SCI subjects (83%) who were employed, 269 reported that the pain interfered with their work. A total of 118 SCI subjects found that the pain was severe enough to stop social activity. Pain appeared to be more severe in the evening and at night, interfering with sleep in 325 of respondents (37%). This study clearly pointed out the importance of chronic pain in determining disability and morbidity in SCI patients (Rose et al 1988). Another survey in the Netherlands found 63.8% of respondents experienced high pain levels (Heutnik et al. 2011). NSW ACI Pain Network (2013) found that neuropathic pain was the most distressing for people with SCI.