Study on the characteristics of pain in patients with spinal cord injury

Abstract

Aside from the loss of functionality after a spinal cord injury (SCI) pain is considered one of the most disabling complications experienced in the rehabilitation process, even with the significant advances in understanding the physiopathology and treatment of the pain, the approach to this symptom is still precarious in spinal cord injury. Objective: To describe the characteristics of pain in this population and to associate the pain between variables such as the type of injury, the interference in the daily living activities (DLA), and its onset. Method: It is a descriptive cross-sectional study and was conducted on 77 patients with spinal cord injuries; the survey was applied using a semi-structured interview. Mean and standard deviation and absolute and relative frequencies were calculated, and for the association between qualitative variables we used the Chisquare test (χ²). Results: The mean age was 38.26 ± 12.43 years, 84.4% of which were men, and 80.5% were paraplegics. Thirty-one were caused by motor vehicle crashes and twenty-nine were by gunshot; 61% of them were fully disabled. As for the pain, 44.2% reported severe pain and 29.8% moderate, 50.6% felt no pain above the lesion, but 58.4% felt it below. Thirty-nine patients reported feeling burning pain, 40% reported that the pain came in the first year after SCI. Pain intensity was 5.44 ± 3.18 points, with 5.20 ± 3.07 in men and 6.75 ± 3.54 in women; for tetraplegic individuals it was 4.13 ± 3.18 and with 5.76 ± 3.12 in the paraplegics. For 27 patients the pain worsened if they remained in the same position, improved to 22 by performing physiotherapy, and to 21 with a change in position. For 68.8% of the patients the pain did not interfere with their DLAs. Twenty-eight used analgesics. It was significantly mentioned that the presence of pain below the lesion interferes with the DLAs (p = 0.04) and appears in the first year after injury above and below the lesion (p = 0.05 and p = 0.01), respectively. Conclusion: Pain was prevalent in those with injured spinal cords, more evident in women, and for the majority arose in the first year after injury and interferes with their DLA. Physiotherapy and a change of position decreased the pain. Therefore, orientations and interventions by the multidisciplinary team should be immediate after the injury, because the prevention or reduction of this complication will lead to an improved quality of life and the re-adaptation of the patient to their family and social life.