• The Donovan SCI Pain Classification System proposes 5 pain types:
    1. Segmental nerve/cauda equina
    2. Spinal cord
    3. Visceral
    4. Mechanical
    5. Psychic
  • It combines both mechanistic factors (e.g. slow fibre conduction from skin) and descriptive factors, such as time to onset post-injury, characteristics of pain (e.g. burning, stabbing, dull aching, etc), pain duration, and factors that make it worse or better.

Clinical Considerations

The assessment can be time-consuming for those patients with complex pain issues. However, this type of approach may be more suitable for difficult cases as it allows the patients to explain pain in their own language rather than being forced to pick specific descriptors for their pain.

ICF Domain

Body Function ▶ Sensory Function

Administration

  • This information is obtained through a semi-structured, pen and paper interview.
  • Up to 40 minutes is required for those with complex issues.

Number of Items

5 possible categories for each pain area.

Equipment

None

Languages

English

Training Required

No formal training required. However, knowledge of pain is beneficial.

Availability

Can be found here.

# of studies reporting psychometric properties: 2

Presenting the information in a table format (like the one below) facilitates interpretation and clarity. The table below presents the descriptors for 5 different patients with each type of pain (examples for each category shown).

Pain Type Time of Onset Post Injury Character Duration Aggravating factors Diminishing factors Possible causative factors
Segmental nerve
Cauda Equina		 Days to weeks Burning
Stabbing		 Seconds Rest Activity Slow fibre conduction from skin
Spinal Cord Weeks to months Tingling
 Numbness Constant Activity Rest All fibre conduction within cord
Visceral Weeks to months Burning Constant Variable Variable Slow fibre conduction from viscera
Mechanical Weeks to months Dull 
Aching Variable Activity Rest Slow fibre conduction from muscles or ligaments
Psychic Variable Variable Variable Variable Variable Preoccupation with unpleasant environmental stimuli

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

Reliability – Moderate

  • Overall test-retest reliability is 78%; percentage agreement for segmental nerve/cauda equine was 67%, for visceral was 75%, for mechanical was 80% and for spinal cord was 84%.
  • Intra-rater agreement ranged from 67-83%.
  • Inter-rater agreement ranged from 62-73%.

(Richards et al. 2002; Putzke et al. 2003)

Validity

No values were reported for the validity of the Donovan SCI Pain Classification System for the SCI population.

Responsiveness

No values were reported for the responsiveness of the Donovan SCI Pain Classification System for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the Donovan SCI Pain Classification System for the SCI population.

Reviewers

Dr. Carlos L. Cano-Herrera, Tyra Chu

Date Last Updated

31 December 2024

Putzke JD, Richards JS, Ness T, Kezar L. Test-retest reliability of the Donovan spinal cord injury pain classification scheme. Spinal Cord 2003;41:239-241.
http://www.ncbi.nlm.nih.gov/pubmed/12669088

Richards JS, Hicken BL, Putzke JD, Ness T, Kezar L. Reliability characteristics of the Donovan spinal cord injury pain classification system. Arch Phys Med Rehabil 2002;83:1290-1294.
http://www.ncbi.nlm.nih.gov/pubmed/12235610

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