Pain location and functioning in persons with spinal cord injury.

BACKGROUND

The influence of pain location and extent on functioning in persons with spinal cord injury (SCI) and chronic pain is not well understood.

OBJECTIVE

To investigate the correlations between pain location and extent to determine which pain domains may be important to assess and potentially target in treating chronic pain in SCI populations.

DESIGN

Prospective, observational study.

SETTING

University medical center.

PARTICIPANTS

A total of 259 persons with an SCI and chronic pain.

METHODS

Postal mail survey questionnaire.

MAIN OUTCOME MEASUREMENTS

Pain sites, pain extent (number of sites), pain intensity in specific body locations, pain interference, and physical and psychological functioning.

RESULTS

A positive association between pain extent and intensity with pain interference (r = 0.33, P < .01) and a negative association with psychological functioning were noted in the study sample (r = -0.21, P < .01). Pain intensity in the lower back and legs (r = 0.55, P < .01) and a number of other sites showed strong associations with patient functioning. Correlation with psychological functioning was significant but weaker (r = -0.22, P < .01 for the lower back and legs). Ambulatory status had only a small moderating effect on the associations between pain intensity in specific sites and pain interference and no effect on psychological functioning.

CONCLUSIONS

The findings support the importance of assessing pain intensity at specific locations as a part of a thorough evaluation of chronic pain, as well as the importance of addressing pain at multiple sites, when managing pain in persons with an SCI.