A SURVEY OF PAIN DURING REHABILITATION AFTER ACUTE SPINAL-CORD INJURY

There has been little research on pain in the acute phase of spinal co rd injury (SCI) rehabilitation. This study surveyed the pain experienc e and management strategies in such patients. The subjects consisted o f inpatients who were undergoing rehabilitation following their acute injury, and were assessed regarding the presence and type of any pain upon admission to the rehabilitation ward, and reviewed weekly during their stay. They were reassessed on reporting any new pain. Pain inten sity was recorded on a Visual Analogue Scale. The maximum intensity of pain during admission was compared to that at discharge. All interven tions directed at pain management were documented. Patients were revie wed one year after discharge regarding current pain experience. Almost all of the patients (n = 23; 96%) experienced pain at some stage duri ng their inpatient rehabilitation. Overall pain intensity for those pa tients with pain during inpatient admission decreased by the time of d ischarge. At the one year review however, pain intensity tended toward s that seen on admission. The reasons for pain tending to increase aft er discharge were not apparent. Neuropathic and Myofascial Pain Syndro me (MPS) were the most common types of pain experienced. A combination of pharmacological, interventional, physical and psychological approa ches were used in pain management. At one year review, neuropathic pai n remained common while MPS and orthopaedic pain had decreased. Pain i s a common and significant problem for many SCI patients and is a chal lenge for the treating team to manage.