Abstract
Pain is a serious consequence of spinal cord injury (SCI). Our aim was to investigate
the temporal aspects of different types of pain following traumatic SCI and to determine
possible predictors of neuropathic pain. Prospective data on 90 patients were collected
at 1, 6, and 12 months after traumatic SCI. The patients completed questionnaires
on pain severity, descriptors, and impact and underwent clinical examination with
bedside sensory testing. Eighty-eight patients completed the 12-month follow-up. Approximately
80% of patients reported any type of pain at all 3 time points. Neuropathic pain related
to SCI increased over time, and musculoskeletal pain decreased slightly, with both
being present in 59% of patients at 12 months; other neuropathic pain not related
to SCI and visceral pain were present in 1 to 3%. At-level neuropathic pain present
at 1 month resolved in 45% and below-level pain resolved in 33%. Early (1 month) sensory
hypersensitivity (particularly cold-evoked dysesthesia) was a predictor for the development
of below-level, but not at-level, SCI pain at 12 months. In conclusion, the present
study demonstrates phenotypical differences between at-level and below-level SCI pain,
which is important for future studies aiming to uncover underlying pain mechanisms.
Perspective
The finding that early sensory hypersensitivity predicts later onset of below-level
central neuropathic pain may help to identify patients at risk of developing neuropathic
pain conditions after traumatic spinal cord injury. Information about onset of pain
may help to identify different phenotypes in neuropathic pain conditions.
Key words
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Article info
Publication history
Published online: November 21, 2013
Accepted:
September 16,
2013
Received in revised form:
September 4,
2013
Received:
June 11,
2013
Footnotes
This work was supported by the Velux Foundation; Karolinska Institutet Strategic Research program in Health Care Research; the Norrbacka Eugenia Foundation; the Swedish Cancer & Traffic Injury Society Fund; and ALF grant from Stockholm County.
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
