Patterns of pain and non-painful sensations experienced during the first 12 months after spinal cord injury.

Abstract

To describe the prevalence, interference, and intensity of subtypes of pain (at-level and below-level neuropathic pain [NeuP] and axial and limb musculoskeletal [MSK] pain) and the prevalence of non-painful sensations (NPS; unpleasant and non-unpleasant) experienced during the first 12 months after spinal cord injury (SCI) DESIGN: A prospective cohort study with clinician assessment of pain and survey administration at three timepoints SETTING: Four academic SCI rehabilitation centers PARTICIPANTS: 189 individuals, English-speaking and aged 18 or older, with complete and incomplete acute traumatic SCI, with or without pain INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: : International SCI Pain Basic Data Set RESULTS: At baseline, at-level NeuP and axial neck and upper back MSK pain were most reported, while at 12 months, at-level and below-level NeuP were, with the percentage of participants with at-level NeuP remaining stable from baseline to 12 months. During the year, the percentage of participants reporting below-level NeuP steadily increased, while the percentage with all types of MSK pain decreased. Electrical and stabbing related and thermal related descriptors were used more frequently to describe pain as compared to describing NPS, while numbness and tingling related descriptors were the most frequently used descriptors for both pain and NPS. Pain intensity and interference were variable throughout the year. At-level NeuP remains consistent and MSK pain resolves over the first year for most people. However, more people develop below-level NeuP as the first-year progresses. Pain intensity and interference are variable, presenting without clear pattern during this time-period.