Identifies 11 types of pain for those with spinal cord injury according to the lesion level.
| Above the lesion level | At the lesion level | Below the lesion level |
|---|---|---|
| 1. Myofacial 2. Syringomyelia 3. Non spinal cord |
4. Radicular 5. Hyperalgesic border reaction 6. Fracture 7. Myofacial (incomplete lesion) |
8. Diffuse burning 9. Phantom 10. Visceral 11. Myofacial (incomplete lesion) |
Clinical Considerations
- The classification system does not follow a systematic method for acquiring the data from the patients, thus obtaining consistent information from one time to another or between individuals very difficult.
- This system is very clinician dependent as it requires considerable knowledge about the various origins of pain to be able to interpret the patient’s comments into the defined classification scheme.
- Although this system has merit for giving more categories for which to describe the various types of pain an individual may have, it most likely would be useful for more complex pain cases where more time is allocated towards understanding the origins of the individual’s pain.
ICF Domain
Body Function ▶ Sensory Functions
Administration
- Clinician-administered; information is obtained through a semi-structured interview.
- This pain classification allows the clinician to describe the general location and whether the pain differentiates between several types of pain.
- Administration time is usually 15-20 minutes, but it may take longer for more complex cases.
Number of Items
N/A
Equipment
None
Languages
N/A
Training Required
- No formal training required. However, knowledge of neuro-anatomy and physiology – specifically sensation and theories of pain is beneficial.
- This system requires considerable knowledge from the clinician classifying the pain as well as from other health care professionals who may be using the information to help with pain management.
Availability
Can be found in the appendix of the following article: https://pubmed.ncbi.nlm.nih.gov/12820785/
# of studies reporting psychometric properties: 1
Interpretability
MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI
Reliability
Low to Moderate Inter-rater reliability between 3 raters:
Kappa coefficient = 0.33 – 0.65
Rate of agreement across all raters was 17%.
(Putzke et al. 2003)
Validity
No values were reported for the validity of Tunk’s Classification Scheme for the SCI population.
Responsiveness
No values were reported for the responsiveness of Tunk’s Classification Scheme for the SCI population.
Floor/Ceiling Effect
No values were reported for the presence of floor/ceiling effects in the Tunk’s Classification Scheme for the SCI population.
Reviewers
Nicole Elfring, Matthew Querée, Joanne Chi
Date Last Updated
15 July 2019
Putzke JD, Richards JS, Ness T, Kezar L. Interrater reliability of the International Association for the Study of Pain and Tunks’ spinal cord injury pain classification schemes. Am J Phys Med Rehabil 2003;82:437-440.
http://www.ncbi.nlm.nih.gov/pubmed/12820785
Tunks E. Pain in spinal cord injured patients. In: Bloch R, Basbaum M (ed). Management of Spinal Cord Injuries. Williams and Wilkins, Baltimore, MD, 1986: p 180-211.
http://scholar.google.ca/scholar?hl=en&q=Pain+in+spinal+cord+injured+patients+tunks&btnG=&as_sdt=1%2C5&as_sdtp=
