TY - JOUR
T1 - Is There a Relationship between Chronic Pain and Autonomic Dysreflexia in Persons with Cervical Spinal Cord Injury?
AU - Widerström-Noga, Eva
AU - Cruz-Almeida, Yenisel
AU - Krassioukov, Andrei
PY - 2004/2/1
Y1 - 2004/2/1
N2 - The purpose of this study was to define the relationships among clinical characteristics of chronic pain, injury characteristics, affective factors and autonomic dysreflexia (AD) in people with chronic cervical spinal cord injury (SCI). A survey containing questions concerning the presence of AD, demographic factors, clinical characteristics of pain and affective symptoms, was mailed to people with traumatic SCI and chronic pain included in the Miami Project to Cure Paralysis database. Of all subjects (n = 330) reporting chronic pain in a previous study, 181 had cervical injuries. Of this subset, 117 (64.6%) participated in the study. Thirty-five people (29.9%) reported AD in our study. Although intense pain has previously been reported to trigger AD, the average pain intensity was not predictive of AD. Pair-wise comparisons indicated that people reporting AD marked significantly more painful areas in the drawing and used more descriptive pain adjectives. Anxiety and sadness were significantly more frequent among people with AD. Furthermore, aggravation of pain due to muscle spasms, infections, full bladder, and constipation was significantly more common among people with AD. The logistic regression analysis indicated that a combination of having widespread pain, experiencing aggravation of pain due to infections, having a complete injury, and experiencing anxiety significantly predicted AD. Our results suggest that relationships between chronic pain and AD exist. Since multiple pain types are common after SCI and may be associated with AD, it is important to determine which pain types that may be particularly important for the condition of AD.
AB - The purpose of this study was to define the relationships among clinical characteristics of chronic pain, injury characteristics, affective factors and autonomic dysreflexia (AD) in people with chronic cervical spinal cord injury (SCI). A survey containing questions concerning the presence of AD, demographic factors, clinical characteristics of pain and affective symptoms, was mailed to people with traumatic SCI and chronic pain included in the Miami Project to Cure Paralysis database. Of all subjects (n = 330) reporting chronic pain in a previous study, 181 had cervical injuries. Of this subset, 117 (64.6%) participated in the study. Thirty-five people (29.9%) reported AD in our study. Although intense pain has previously been reported to trigger AD, the average pain intensity was not predictive of AD. Pair-wise comparisons indicated that people reporting AD marked significantly more painful areas in the drawing and used more descriptive pain adjectives. Anxiety and sadness were significantly more frequent among people with AD. Furthermore, aggravation of pain due to muscle spasms, infections, full bladder, and constipation was significantly more common among people with AD. The logistic regression analysis indicated that a combination of having widespread pain, experiencing aggravation of pain due to infections, having a complete injury, and experiencing anxiety significantly predicted AD. Our results suggest that relationships between chronic pain and AD exist. Since multiple pain types are common after SCI and may be associated with AD, it is important to determine which pain types that may be particularly important for the condition of AD.
KW - Autonomic dysreflexia
KW - Chronic pain
KW - Pain intensity (NRS)
KW - Spinal cord injury
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U2 - 10.1089/089771504322778659
DO - 10.1089/089771504322778659
M3 - Article
C2 - 15000760
AN - SCOPUS:1242276190
VL - 21
SP - 195
EP - 204
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
SN - 0897-7151
IS - 2
ER -