Pain and dysesthesia in patients with spinal cord injury: A postal survey

Study design: A postal survey. Objectives: To assess the prevalence and characteristics of pain and dysest hesia in a community based sample of patients with spinal cord injury (SCI) with special focus on neuropathic pain. Setting: Community. Western half of Denmark. Methods: We mailed a questionnaire to all outpatients (n = 436) of the Vibo rg rehabilitation centre for spinal cord injury. The questionnaire containe d questions regarding cause and level of spinal injury and amount of sensor y and motor function below this level. The words pain and unpleasant sensat ions were used to describe pain (P) and dysesthesia (D) respectively. Quest ions included location and intensity of chronic pain or dysesthesia, degree of interference with daily activity and sleep, presence of paroxysms and e voked pain or dysesthesia. temporal aspects, alleviating and aggravating fa ctors, McGill Pain Questionnaire (MPQ) and treatment. Results: Seventy-six per cent of the patients returned the questionnaire, ( 230 males and 100 females). The ages ranged from 19 to 80 years (median 42. 6 years) and time since spinal injury ranged from 0.5 to 39 years (median 9 .3 years). The majority (>75%) of patients had traumatic spinal cord injury . Of the respondents, 77% reported having pain or unpleasant sensations, an d 67% had chronic pain or unpleasant sensations at or below lesion. Forty-e ight per cent reported that P/D could be evoked by non-noxious stimulation of the skin indicating that allodynia is present in almost half of the pati ents. Forty-three per cent of respondents took analgesics, 7% received anti depressants or anticonvulsants. Conclusion: This survey suggests that pain and dysesthesia are common and s erious complaints in SCI patients, Unexpectedly, only 7% of the patients we re treated with drugs considered to be most effective in neuropathic pain. This emphasizes the need for a continued research and education on PI:D in SCI.