SCI Health Series: SCI & Pain

The irony of a spinal cord injury is that many people suffer from chronic pain. There is widespread belief that people with spinal cord injuries don’t feel anything when it is in fact the opposite. Unfortunately, pain is the leading sensation many people with spinal cord injuries report other than numbness, and the reasons for the pain are varied. Often, the chronic pain is caused by the spinal cord injury itself.

Neuropathic Pain

With a spinal cord injury, the brain/spinal cord connection can become confused when trying to interpret pain or other signals. And when it becomes confused, it will interpret any sensation as pain, which can be insufferable to live with.

This type of pain is called neuropathic/neurogenic pain and is often felt as a burning, stabbing or tingling sensation. Several methods are used to treat this type of pain since it is caused by abnormal communication between the spinal cord and the brain. Here are the most common treatments:

Various oral medications are used, with anti-depressants often the first line of treatment. If the pain is not alleviated, narcotics like codeine and some morphine can be used, but they are not often chosen as a treatment option because of their addictive nature. Anti-seizure medications have also been used with success, but anti-depressants more so. When you’re depressed, pain is usually heightened.

Some of the anti-depressants used to treat neuropathic pain are serotonin norepinephrine reuptake inhibitors (SSNRIs) like venlafaxine (Effexor) and tricyclics, such as amitripltyline (Elavil). If no improvement is seen through medication options, a dorsal column stimulator can be implanted into the spinal canal to treat pain that is caused by root damage at the nerve.

Other common drugs used to treat pain include non-steroidal anti-inflammatory drugs like aspirin and ibuprofen. Anti-muscle spasm medication is frequently used, too, such as Baclofen or Valium. In addition, therapeutic massage, acupuncture and physical therapy are used to alleviate pain.

Musculoskeletal/Spasm Pain

Another kind of pain many experience is musculoskeletal pain. This is typically caused by overuse or strain of the upper body following a spinal cord injury. From using one’s shoulders too muchfor pushing to using one’s wrists too much to type, this type of pain gets worse by ignoring it. Only rest allows it to get better.

Activity modification is typically used to treat musculoskeletal pain. You should also look at the equipment you’re using, from your wheelchair to your seating, to see if anything can be changed or modified to make it work better for your body. You can also work on improving your transfer or wheelchair-pushing technique.

Figuring out how to manage your pain after a spinal cord injury can be a long road, but don’t lose hope. Also, consider psychological treatments such as relaxation techniques or even psychotherapy to help. A lot of pain can stem from mental unrest.

What kind of pain do you have and how do you treat it?

Learn more

Pain after Spinal Cord Injury

Pain: Reeve Foundation

Pain Management following Spinal Cord Injury

SCI Pain Videos

Perspectives on Pain: A Spinal Cord Injury Panel Discussion

Managing Chronic Pain after Spinal Cord Injury

Spinal Cord Injury ~ Injury Level? Nerve Pain? Referred Pain? What?

SCI Superstar: Kristin Beale

Not everyone with a SCI is as determined as Kristin Beale was after her injury, but that is what makes Kristin so amazing. When she became paralyzed, she refused to accept the limitations doctors predicted she would face as a result of her “complete” injury, and she was intent on proving them wrong.

These days, you can just call her the Queen of Activity-Based Rehab, because that is what she utilized to gain more function than any medical doctor would have expected. And her accomplishments are impressive, from becoming a prolific hand cyclist to publishing a book.

Why She Shines

Growing up, sports were a huge part of Kristin’s life, with cheerleading and lacrosse as her favorites. But at 14 her life changed when she was involved in an accident on a lake in North Carolina. “I was involved in a jet ski accident in 2005 that resulted from driver inattention and a collision of two jet skis. I now have a T8 spinal cord injury,” she says. Beale also suffered a brain injury leaving her with short-term memory loss.

Following the accident, Kristin was rushed through the mainstream hospital and rehab process, but she was not happy with the traditional rehab experience and wanted something more. “Two weeks out of the hospital,” she recalls, “I flew to California for an intensive rehabilitation gym (four hours daily, five days per week) and came home with the ability to wiggle my toes.”

The gym, Project Walk, is a big proponent of activity-based rehab. But Kristin ended up switching rehab facilities after discovering Awakenings, another California rehab facility, where she learned how to crawl on her first visit. So impressed with the trainers there, Kristin returned to Awakenings seven more times.

She also discovered something else in rehab – adaptive sports. She tried adapted tennis, surfing, lacrosse, and a few others, but she was quickly drawn to hand cycling. She loves how the sport takes the pity out of the equation, instead leaving people impressed by her abilities. She has participated in seven marathons to date. Her first, the New York Marathon, was in 2011; her favorite is the Marine Corps Marathon.

To help pay for her to participate in hand-cycling events, Achilles International, a nonprofit for SCI athletes, has sponsored six of her hand-cycling experiences. Achilles International is an offshoot of the Christopher and Dana Reeve Foundation and does great things in the SCI/sports community.

What’s Next

It hasn’t been just gyms and marathoning in Kristin’s life. She fell in love with writing in high school, put it on hold after her injury, but has since picked it up again. She’s been a feature writer for Action Magazine, several newsletters and online blogs, and has also written a book. “My writing allows me to be more candid and honest that I’m ever able to in real life,” she says. “Partly because I’m a well-mannered girl and partly because the opportunity to express myself isn’t constant, a lot of perspective is lost.”

With my writing, I have a chance to express myself and record those perspectives,” she continues. “That’s a big reason why publishing a book is scary: people have privilege to however much of yourself you’re willing to expose which, in the case of my book, was everything.”

At the age of 26 last year, Greater Things was published. It chronicles Kristin’s life since her injury, specifically how sports have changed her life. It also gives a glimpse into her everyday life in hopes of giving the reader a deeper perspective about life with a spinal cord injury.

“I didn’t have the idea to make my writing into a book until recent years,” she says. “Since high school I was writing stories, editing them, and storing them in a folder on my computer for no one’s benefit. A Christmas gift to my family in 2014 was a self-published book of all those stories – organized into chapters and only intended to be a great Christmas gift. After I gave them the books, I had the small idea to make something more succinct. I wrote eight to 10 more stories, worked with a local editor, and developed the dream of a published book.”

After a year of pitching her manuscript, it was picked up by Morgan James Publishing. “My dreams came true in my writing becoming a book and in finding the perfect publisher,” Kristin says. Her book is now available at bookstores nationwide (link below).

Currently living in her first home in Richmond, Virginia, with her trusty dog Achilles by her side, Kristin is proud of how far she has come – and she has big writing dreams. “I would love to never go back to an office job, continue to publish books, and be on the Ellen DeGeneres Show,” she says. “Also, I would love to become a best-selling author and have someone make a movie of my story. Pretty typical dreams of an author.”

Have you written your life story What writing tips do you have for others with SCI who want to tell their life stories?

– Visit her official site: KristinBeale.com

– Buy her book on Amazon: Greater Things

Watch Videos of Kristin

Jet Ski Accident Victim Learns to Walk Again – Kristin Beale

Interview with Kristin Beale on “Overcoming Obstacles”

Motivational speech by Kristin