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?