CLASSIFICATION OF PAIN FOLLOWING SPINAL-CORD INJURY

Pain continues to be a significant management problem in people with s pinal cord injuries. Despite this there is little consensus regarding the nature, terminology and definitions of the various types of pain t hat occur following spinal cord injury. This has led to large variatio ns in the reported incidence and prevalence of pain following spinal c ord injury. Treatment studies have been hampered by inconsistent and i naccurate identification of pain types. We believe that both research and management would benefit from an agreed upon classification system which accurately and reliably identifies the types of pain that occur following spinal cord injury. We have reviewed the literature on the classification of pain following spinal cord injury and have developed a classification system which adopts the strengths of previous system s and attempts to avoid the weaknesses inherent in others. Our propose d classification system of pain following spinal cord injury includes four major divisions: musculoskeletal, visceral, neuropathic and other types of pain. We have divided neuropathic pain on the basis of regio n into two subdivisions: neuropathic at level and neuropathic below le vel pain. We have further divided neuropathic at level pain into two c ategories: radicular and central, to indicate the presumed site of the lesion responsible for pain generation. We believe that our proposed classification system is comprehensive, simple and readily applicable in the clinical and research situation. It is our hope that this propo sed classification will contribute to the eventual development of a un iversal system for the classification of pain following spinal cord in jury.