Mariano A J
Veterans Affairs Medical Center, Seattle, Washington 98108.
Clin J Pain. 1992 Jun;8(2):87-92. doi: 10.1097/00002508-199206000-00005.
With the medical progress that has given spinal cord injured individuals greater longevity and better overall health, chronic pain has emerged as a major challenge in treating this population. Over the past 40 years, estimates of prevalence of severe/disabling chronic pain in spinal cord injury (SCI) patients have ranged from 18% to 63%. Beyond this finding, the extant literature is extremely limited. This review summarizes the empirical findings with regard to the prevalence and clinical significance of chronic pain in the SCI population. In spite of widespread clinical beliefs, there is little evidence that characteristics of the SCI such as the level, completeness, or etiology of the injury are associated with either the development or severity of pain. Until recently, psychosocial issues have been almost totally ignored in spite of the importance such variables have demonstrated in chronic pain in other populations. A major purpose of the present article is to expand the scope of inquiry to include these factors and to emphasize the importance of employing a biopsychosocial model. Evidence is reviewed which suggests that chronic pain is associated with psychosocial impairment in this population. It is concluded that rather than being a minor problem in comparison to the other limitations imposed by SCI, chronic pain represents a significant additional challenge to the SCI patient that may be best addressed by a multidisciplinary approach.
随着医学的进步，脊髓损伤患者的寿命得以延长，整体健康状况得到改善，慢性疼痛已成为治疗这一群体的一大挑战。在过去40年里，脊髓损伤（SCI）患者中重度/致残性慢性疼痛的患病率估计在18%至63%之间。除了这一发现之外，现有文献极为有限。本综述总结了关于SCI人群慢性疼痛患病率和临床意义的实证研究结果。尽管临床普遍认为，几乎没有证据表明SCI的特征（如损伤水平、完整性或病因）与疼痛的发生或严重程度相关。直到最近，心理社会问题几乎完全被忽视，尽管这些变量在其他人群的慢性疼痛中已显示出重要性。本文的一个主要目的是扩大研究范围，将这些因素纳入其中，并强调采用生物心理社会模型的重要性。本文回顾的证据表明，慢性疼痛与该人群的心理社会功能损害有关。结论是，慢性疼痛并非与SCI造成的其他限制相比是一个小问题，而是对SCI患者的一个重大额外挑战，多学科方法可能是应对这一挑战的最佳方式。
