Relationships among clinical characteristics of chronic pain after spinal cord injury

Objective: To define relationships among various clinical characteristics of pain occurring after spinal cord injury (SCI). Design: Postal survey. Setting: General community. Participants: Of 330 subjects with SCI reporting chronic pain in a previous survey, 217 volunteered.Interventions: Not applicable. Main Outcome Measures: Detailed pain history. Results: Participants had been injured for an average of 8.2 ± 5.1 years and 55.4% were tetraplegic. Most subjects marked multiple areas on a pain drawing with the back area most frequently (61.8%) indicated. The most common qualities reported were burning pain (59.9%) and aching pain (54.4%). Burning was significantly associated with pain in frontal parts of torso and genitals, buttocks, and lower extremities, whereas aching was significantly associated with neck and shoulders and back. The factor analysis of the relationships between level of injury, location of pain, quality of pain, pain intensity rating, duration of pain breaks, and time for pain onset resulted in 3 groupings: (1) multiple pain locations, burning pain, lower extremity; (2) aching pain, shoulder and neck, cervical injury; and (3) early onset of pain, no breaks to short breaks of pain, and high average pain intensity. Conclusions: Relationships among various clinical features of pain after SCI reveal common clinical patterns important for increased understanding of pain mechanisms and for the design of therapeutic interventions for pain management.