Classification of chronic pain associated with spinal cord injuries

Diana D. Cardenas, Judith A. Turner, Catherine A. Warms, Helen M. Marshall

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Objectives: To determine interrater reliability of a classification system for chronic pain in persons with spinal cord injury (SCI) and to determine the frequency and characteristics of various pain types as categorized by this system. Design: Independent categorization (based on questionnaires; for 15 persons, questionnaires plus personal interviews) by 2 investigators. Setting: Community. Participants: A total of 163 individuals aged ≥18 years with SCI and pain. Interventions: Not applicable. Main Outcome Measures: Pain categories, Short-Form McGill Pain Questionnaire, and Chronic Pain Grade questionnaire. Results: Among 41 (25%) questionnaires categorized independently by 2 investigators, strength of agreement in categorizing 68 pain problems was substantial (K=.68). For 15 persons whose pain was categorized in person by 2 investigators, strength of agreement was also substantial (K=.66). Among 163 survey respondents with pain, the most common worst pain was SCI pain (31.9%). Mean characteristic pain intensity ± standard deviation for worst pain, regardless of type, was 61.02±18.5 on a scale from 0 to 100. On average, for worst pain, respondents reported moderate pain-related disability (43.70±29.4; scale range, 0-100). Although certain pain descriptors were more often associated with a specific type of pain, none was pathognomonic. Conclusions: Substantial interrater reliability was achieved in determining pain categories by use of responses to a questionnaire with a classification system based on presumed pathology. Adding interviews with patients increased our ability to classify pain but did not improve overall interrater reliability.

Original languageEnglish (US)
Pages (from-to)1708-1714
Number of pages7
JournalArchives of physical medicine and rehabilitation
Issue number12
StatePublished - Dec 1 2002


  • Pain
  • Rehabilitation
  • Spinal cord injuries

ASJC Scopus subject areas

  • Rehabilitation


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