After a spinal cord injury, a persons sensory, motor and reflex messages are affected and may not be able to get past the damage in the spinal cord. A spinal cord injury is the result of damage to any portion of the spinal cord or the nerves at the base of the spine. Chronic pain following spinal cord injury pubmed central pmc. Regional spinal cord injury center of the delaware valley spinal cord injury manual the regional spinal cord injury center of the delaware valley provides a comprehensive program of patient care, community education, and research. Spinal cord injury and chronic pain bja education oxford. Types of pain that can be experienced after spinal cord injury. We know far more about nociceptive pain mechanisms than neuropathic pain mechanisms. In most spinal cord injuries, the vertebrae pinch the spinal cord. Chronic pain is a common and often debilitating problem that can significantly impact function and quality of life for patients with spinal cord injury. Spinal cord injury spinal cord shock neck pain resources. Spinal cord essentials is a patient and family education initiative from university health network toronto rehabilitation institutes brain and spinal cord injury rehabilitation program. The majority of people with sci report that they have chronic pain.
Authorship please see the spinal cord injury model systems consumer information publication pain after spinal cord injury for information about authorship. American spinal injury association asia classification d. In the majority of cases the cord is crushed destroying nerve cells and nerve tracts or pathways at that specific level within the cord. Acute pain is common after a spinal cord injury sci. Scott richards, phd, trevor dysonhudson, md, thomas n. The primary injury, in large part, determines a given patients neurologic grade on admission and thereby is the strongest prognostic indicator. The spinal cord is a bundle of nerve fibers and tissue which lies within spine forming the brains connection to the body. To develop the first canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury sci. Pain after spinal cord injury model systems knowledge. Approximately, 200,000 people in the united states have spinal cord injuries sci, and some 10,000 new injuries occur annually. Fracture or shattering of the vertebral bones or intervertebral discs may lead to the puncture of the spinal cord with resulting loss of feeling and function in parts of the body. Pain is a common health concern after spinal cord injury sci.
Approximately, 200,000 people in the united states have spinal. Chronic pain of both neuropathic and nociceptive type is common and contributes to reduced quality of life. If youve suffered a spinal cord injury, your life is in danger, and youll know youre injured. Paraplegia from spinal cord injury after thoracic epidural c. Pain can come from any part of the body, including the muscles, joints, organs, skin, and nerves. Thus, effective, safe, and novel therapies are needed urgently. Bryce, md, and anthony chiodo, md, in collaboration with the model systems knowledge translation center. Although treatment of sci varies from the north american.
Nerve pain from an sci is called neuropathic pain, and is a common cause of chronic pain after sci. This is where the spinal cord is damaged following major trauma to the spinal cord from a variety of causes. Loss of movement loss of sensation loss of bowel andor bladder control exaggerated reflex actions or spasms changes in sexual function, sexual sensitivity and fertility pain or intense stinging sensation spinal cord injury. No motor or sensory function is preserved in the sacral segments s4s5. The effects of spinal cord injury may include the following. Motor function preserved below neurological level and at least half of muscles have better than grade 35 function e. Previously, docosahexaenoic acid dha was reported to confer neuroprotection in preclinical sci models. Cord trauma due to intracord injection reportedly has distinguished paracentral splitting lesions from hydromyelia on the mri.
Pain after spinal cord injury university of washington. Basic facts spinal cord injury occurs when there is any damage to the spinal cord that blocks communication between the brain and the body. Organisations and health professionals should contact the nsw state spinal cord injury service on 0. Answers to your questions, baltimore, md, 1997, paul h brookes publishing company. Spinal cord injuries can be found in the blue book under section 1. Tips on applying for disability benefits with spinal cord. Check out the september 25, 2019 sci forum revolutionay shoulder care for sci. Spinal cord injury and chronic pain bja education oxford academic. Mar 06, 2015 spinal cord injury sci is an injury to the spinal cord that leads to varying degrees of motor andor sensory deficits and paralysis. The spinal cord after injury a spinal cord injury can occur either from trauma or from a disease. Spinal cord damage results in a loss of function, such as mobility or feeling. To develop the first canadian clinical practice guidelines for treatment of neuropathic pain in people with spinal cord injury sci.
But you may also feel pain in an area where otherwise you have no feeling. Pain after spinal cord injury northwest regional spinal cord. Normal motor and sensory function but asia grade e does not describe pain, spasticity and dysesthesia that may result from spinal cord injury. If you have more than one pain problem, please dowload the additional pages of the questionnaire and repeat these questions for your 2nd and 3rd worst. Neck pain associated with stretching, bruising, compression, severance, or laceration, can all cause injury to the spinal cord resulting in dysfunction.
Imaging studies eliminated cord compression that is commonly caused by epidural hematoma, spinal stenosis, or metastatic lesions. Pain after spinal cord injury spinal cord injury model systems consumer information people often use words such as burning, stabbing or tingling to describe neuropathic pain, but neuropathic pain varies a great deal from person to person. Spinal cord injury may be divided into both primary and secondary mechanisms of injury. For this reason and because nociceptive pain transmission is the same in sci and nonsci patients, we focus on understanding how the injured spinal cord goes on to develop chronic neuropathic pain. In their algorithm, they described nociceptive and neuropathic pain as the two major types of pain encountered in spinal cord injury as previously reported by the international association for the study of pain of 2000. In most people who have acute, traumatic spinal cord injury, the spinal cord is not fully severed but is bruised or. An individual with a spinal cord injury sci is likely to. In order to qualify for disability benefits using this listing, you need to provide medical evidence which shows you have damage to your spinal cord. A spinal cord injury is not the sort of thing you have to wonder about having. Further description of the classification can be found at this reference. Original article the international spinal cord injury pain extended data set version 1. It is also common for many individuals with sci to experience chronic pain.
This includes paralysis, bowel and bladder dysfunction, sexual dysfunction, respiratory impairment, temperature regulation problems, and chronic pain. Pain after spinal cord injury information spinal cord. Protecting your shoulders and staying active after spinal cord injury presented by kristin kaupang, physical therapist, on april 10, 2012 at the university of washington medical center, seattle, wa. Types of pain that can be experienced after spinal cord injury the following table identifies most of the common pains experienced after spinal cord injury. Portions of this document were adapted from materials developed by the uab sci model system, university of michigan model sci care. Spinal cord essentials my bowel care program spinal. Inspired is a spinal cord injury support forum which offers support for those affected by spinal cord injuries, their families and carers. The balance shall be physicians, other allied health professionals, administrators of brain and spinal cord injury programs, and representatives from support groups that have expertise in areas related to the rehabilitation of individuals who have brain or spinal cord injuries.
It can be felt in areas at or below the injury, even if sensation is not present, and is an especially distressing symptom for many people. About half of patients with spinal cord injury sci develop debilitating central neuropathic pain cnp, with no effective treatments. The pain may occur as a result of the damage to the spinal cord, or it may occur from damage to other areas of the body at the time of injury. The international spinal cord injury pain extended data. An estimated 11,000 spinal cord injuries occur each year in the united states and more than 200,000 americans suffer from maladies associated with spinal cord injury. You will be asked to provide proof that your spinal injury has caused nerve root compression. Pdf pain without clinical evidence of sensation is an ironic but frequent phenomenon. To help find treatment solutions, ubc researchers are investigating the effectiveness of a drug called targin at treating chronic pain in individuals with spinal cord injury. Pain is a serious problem for many people with spinal cord injuries sci. An analysis of pain following traumatic spinal cord injury. You cant use symptoms to diagnose the sort of spinal cord injury you have, and every patients prognosis is different. Principles of treatment for neuropathic pain in sci patients are similar to those in nonsci patients.
There are different types of pain, and they are often described in different ways. Pain after sci can occur in parts of the body where there. The objective of this study was to develop the international spinal cord injury pain extended data set iscipeds with the. Protecting your shoulders and staying active after spinal. Pain in a spinal cord injury sci can be complicated and confusing. Fatty acid suppression of glial activation prevents central. Pain management following spinal cord injury queensland health. Pain originating from the spinal cord injury is called neuropathic pain. In our case, the mri showed an intramedullary air bubble and a long segmental and. Management of neuropathic pain associated with spinal cord injury. At a recent showcase of research on sci in western australia, dr alison kirkman and ms bianca burro from the school of physiotherapy at the university of not.
Managing pain for adults with spinal cord injury 3 managing pain following spinal cord injury pain is a common complication after spinal cord injury sci, which can significantly impact upon a persons functional ability and independence, psychological wellbeing, ability to return to work and quality of life. Acute pain occurs soon after onset of a spinal cord injury. It is a federally designated program of thomas jefferson university and its affiliated institutions. The prevalence of pain in these conditions is alarmingly high.634 875 633 878 961 988 954 1498 1098 537 74 884 837 550 460 1321 858 530 1370 549 1315 325 1159 261 576 1155 487 1034 618 212 510 527 564 1494 1268 1211 310 1011 563 1179 904 455