For many patients with spinal cord injuries, pain is a major issue (SCI). Pain can occur in places of the body where there is normal sensation (feeling) as well as locations where there is little or no feeling following a spinal cord injury. The discomfort is palpable and might have a severe influence on one’s quality of life. A person suffering from acute discomfort may find it difficult to carry out daily tasks or engage in pleasurable pursuits.
Chronic pain is reported by the majority of persons with SCI. Pain that does not go away and lasts for months or years is referred to as chronic pain. The source of the pain may be unclear, although it is frequently linked to nerve damage caused by the SCI or musculoskeletal issues that emerge as a result of the SCI. The discomfort might come and go. Chronic pain is difficult to eradicate altogether, but it may frequently be controlled or decreased to the point that it no longer dominates your life.
Chronic pain can exacerbate or create mental health issues such as depression, anxiety, and stress. This isn’t to say that the pain is “all in your brain,” but that pain and worry may exacerbate one other.
Even though pain from a spinal cord injury can be complicated and difficult to manage, there are a variety of therapies that can assist. Understanding your pain, collaborating with your doctor, and being open to different therapies can all help you manage your pain and improve your quality of life. Many people who have suffered from severe chronic pain as a result of a spinal cord injury have found relief utilizing the strategies detailed here.
Different types of pain
A person with SCI may experience a variety of pains in many sites, including those where there is normally no sensation. It’s crucial to know what kind of pain you’re dealing with before deciding on the best remedy. As a result, your doctor will ask you to describe your pain in many ways, such as its location, severity, length of time you’ve had it, what makes it worse or better, and so on. Your doctor may also request that you do tests such as an x-ray or an MRI (magnetic resonance imaging).
Neuropathic pain (also known as “neurogenic pain”) is produced by improper communication between injured nerves and the brain, which interprets nerve impulses that tell your brain how your body feels. It is considered that with neuropathic pain, the brain “misunderstands” the information it receives from around the site of your injury, causing you to feel pain from below where you have little or no feeling. This is why a person might experience neuropathic pain in a region that is devoid of sensation.
People frequently use terms like “burning,” “stabbing,” and “tingling” to characterise neuropathic pain, but it varies greatly from person to person. It is usually difficult to treat, necessitating the use of a mix of therapies.
Muscle, joint, and bone disorders are the sources of musculoskeletal discomfort. It is an issue that all individuals, even those with SCI, face as they get older.
Injury, overuse or strain, arthritic changes, or wear and tear of the joints can all cause musculoskeletal discomfort, which is frequently induced by wheelchair use (including insufficient seating support) and/or transfers. Movement makes it worse, while rest makes it better.
Overuse of the muscles from transfers and pressure relief techniques, as well as pushing a wheelchair, is a common cause of upper limb (shoulder, elbow, and hand) discomfort. It might happen weeks, months, or even years after an accident. Overuse can cause discomfort in the hand, arm, or shoulder in people with higher level injuries who use computers or joysticks for a variety of tasks (reading, talking, controlling the environment). Transferring securely and performing other everyday tasks might be challenging if you have upper limb discomfort.
Back and neck discomfort are quite frequent. Increased mobility slightly above and below the fusion can cause back discomfort in persons with paraplegia who have had surgery to fuse their spine. Back discomfort is common in people with tetraplegia (quadriplegia), especially if they can walk but still have weakness. Neck discomfort can occur in those who use chin- or mouth-operated joysticks.
When muscles and joints are stretched due to spasticity, muscle spasm pain occurs.
Cramping, dull, hurting, and cramping are common symptoms of visceral pain, which occurs in the abdomen (stomach and digestive region). A medical issue such as constipation, a kidney stone, ulcer, gall stone, or appendicitis might cause it. Because a person with SCI may not exhibit the typical symptoms of certain medical problems, it is critical to consult with a doctor who has expertise treating SCI patients in order to receive an accurate diagnosis and treatment.
Pain from a visceral condition can occasionally be felt at a location other than the cause of the problem. Referred pain is the term for this. Gallbladder illness causes shoulder discomfort, which is a frequent example.
Managing pain after SCI
There is no single treatment for pain because it might have so many diverse origins. It’s possible that you and your doctor may need to attempt a mix of medications, therapy, and other therapies, including psychological treatments, and that this will take time to figure out.
Physical treatments and interventions
Modification of activity for musculoskeletal discomfort. Changes in your mobility equipment (wheelchair, sliding board), wheelchair pushing and transfer skills, and how you handle pressure reliefs can all help to reduce muscle and joint discomfort. Muscle-strengthening and joint-balancing exercises can also assist to alleviate musculoskeletal discomfort.
Musculoskeletal pain is treated with physical therapy. Stretching and range-of-motion exercises can help alleviate muscular tension-related discomfort. Exercises that strengthen weak muscles might help to restore balance and relieve discomfort in troublesome joints.