A spinal cord injury (SCI) can cause permanent changes in a person’s strength, feeling, and other bodily functions below the injury site. Pain after an SCI is very common and affects over 80% of patients.
A complete spinal cord injury may disrupt the normal flow of messages between the patient’s brain and body. The brain often misinterprets messages sent from the affected areas as pain, making the problem even more difficult for the patient. At other times, chronic pain may result from secondary complications of spinal cord injury, such as bladder problems or shoulder pain from wheelchair use.
Brooks Rehabilitation is committed to using the latest technology and research-based treatments to provide each patient with the best outcome. Our dedicated and compassionate team work round the clock to provide the best treatment modalities to help SCI patients regain optimal function.
The types of pain that follow an SCI
Spinal cord injury patients may be exposed to several different types of pain. At Brooks Rehabilitation, we understand that every spinal cord injury is different and unique. We also know that everyone experiences pain differently. That’s why we use scientifically proven technology and a holistic approach to provide patient-focused care.
Pain following an SCI can range from mild to severe and may be occasional or consistent, depending on the patient’s condition. There are typically three different types of pain: neuropathic, musculoskeletal, and visceral.
Neuropathic pain is the most common type of pain experienced by SCI sufferers. Many patients describe it as a burning, aching, squeezing, or tight pain that feels like a band around the level of the spinal cord injury. However, in more severe cases it may affect the entire section below the level of the injury.
Neuropathic pain occurs from abnormal communication between damaged nerves and the part of the brain that interprets the extent of the damage after an SCI. Consequently, the brain interprets signals from damaged nerves as pain coming from areas where the patient often has little or no feeling.
Neuropathic pain is usually the most difficult to treat, especially when it happens at the level of the SCI. Often, a combination of treatments by a professional medical team specializing in spinal cord injury may help ease the pain.
Musculoskeletal pain is also common following an SCI. It often becomes more prevalent as people get older. This type of pain is caused by injury, strain or overuse, arthritic changes, or wear and tear on the joints. It gets better with rest but worse with frequent movement.
- Upper limb pain: This pain may result from overuse of the shoulder, elbow, or hand muscles and can occur months or even years after injury. For example, people with higher injury levels who use computers for many activities may develop pain in their shoulder, arm, or hand from muscle overuse.
- Back and neck pain: This type of pain is more common in paraplegic patients who’ve had surgeries to fuse their spine. Frequent increased motion that occurs just above or below the point of the surgery may lead to severe back pain.
- Muscle spasm pain: This type of pain occurs when joints and muscles are strained from spasticity. It’s also very common among spinal cord injury patients.
These muscles may not be accustomed to strain or doing too much work, which results in pain. It’s also worth noting that musculoskeletal pain is often felt above the injury, where sensation isn’t affected.
This type of pain comes from the abdomen and occurs from problems such as ulcers, constipation, appendicitis, or gallbladder. Visceral pain can present itself in different forms, and it can sometimes be difficult to pinpoint its source.
A spinal cord injury patient may not always have symptoms associated with the condition. Therefore, it’s important to seek medical assistance from a health professional with experience caring for SCI patients. Pain that results from visceral problems can sometimes be felt in a different part of the body, away from the source of the injury.
How to manage pain after a spinal cord injury
Unfortunately, there’s still no medically or scientifically proven way to reverse spinal cord damage. But scientists are continuously working on new medicines and treatments that may promote nerve cell regeneration. These studies aim to improve the remaining nerves’ normal functioning after an SCI.
Nevertheless, there are many different ways of treating pain, including medication, physical therapy, surgical treatment, and psychological intervention.
Medications rank at the top of the list of ways researchers and medical experts help improve the lives of spinal cord injury patients. The right medications can minimize inflammation and provide relief from secondary complications following an SCI. Common medications used in alleviating chronic pain following a spinal cord injury include:
Anticonvulsants like gabapentin (GABA) help manage neuropathic pain following a spinal cord injury. These medications help reduce pain by suppressing the overactive transmission of pain signals below the site of the injury.
Many patients suffer from depression following a spinal cord injury. This can result in a lack of energy, changes in eating and sleeping habits, loss of interest in daily activities, and the inability to concentrate. Fortunately, depression can be treated with antidepressants like SSRIs, SNRIs, and psychotherapy by increasing neurotransmitter levels in the patient’s brain to regulate mood and pain perception.
Antispasmodics and Muscle Relaxants
Diazepam (Valium), tizanidine (Zanaflex), and baclofen (Lioresal) are used to treat musculoskeletal and spasm-related pain. These drugs can be taken orally or through direct delivery to the spinal cord. They can cause confusion, sleepiness, and other side effects.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen can help relieve pain after an SCI. NSAIDS are especially effective for patients with mild to moderate pain. They help relieve swelling in the affected area by slowing prostaglandin production, thereby reducing pain perception.
Physical exercise has proved to be very effective in chronic back pain treatment. It’s also one of the main treatments used by patients under the guidance of a qualified spine physical therapist. Our team understands that the same physical treatments don’t work on every patient. That’s why our treatments are tailored to meet each patient’s specific condition and symptoms.
Physical treatments may include:
- Activity modification for musculoskeletal pain
- Physical therapy
- Therapeutic massage
- Transcutaneous electrical nerve stimulation
Maintaining regular physical exercise at home also plays a critical role in the patient’s treatment success.
Some spinal cord injuries may require surgical treatment, particularly when the injuries have caused the patient’s bones to be unstable or when there’s pressure on the spinal cord. The spine won’t be stable if it can move and suffer more damage despite bracing.
Common surgical procedures used in spinal cord injury treatments include:
- Dorsal column stimulator
- Intrathecal pumps
Psychological training techniques can help patients to better manage their pain so it doesn’t take over their lives. Our psychologists at Brooks Rehabilitation are trained in pain management to effectively reduce the impact and intensity of pain.
Common psychotherapeutic interventions include:
- Cognitive behavioral therapy/cognitive restructuring
- Dialectical behavioral therapy
- Individual psychotherapy
- Relaxation techniques and/or feedback
- Self-hypnosis training
How to prevent pain after a spinal cord injury
Because most spinal cord injuries occur due to unpredictable events, patients must do everything they can to reduce or prevent pain after an injury.
Common ways patients can reduce or prevent pain from an SCI include:
- Avoiding alcohol
- Keeping a record of things that affect their pain
- Reducing stress through counseling techniques, such as hypnosis, relaxation training, and biofeedback
- Getting as much rest as possible to improve mood and overall health
- Distracting themselves from symptoms by participating in enjoyable activities
- Getting treatment to cope with chronic pain
- Getting treatment for medical problems to reduce pain
Pain management for SCI patients at Brooks Rehabilitation
Our spinal cord injury programs at Brooks Rehabilitation are the most innovative, scientifically-proven treatments available. Our comprehensive care system offers everything SCI patients need for treatment and recovery.
Brooks Rehabilitation uses a multidisciplinary team to ensure all SCI patients receive the best care possible. If you’re suffering from chronic pain due to an SCI, contact us today for more information – or visit our locations to learn more.