Pain and its management

The pain usually starts a few weeks or months after injury. The symptoms can include pins and needles, burning, stinging or shooting pains. Even though pain after SCI can be complicated and difficult to treat, there are many treatments available that can help. Understanding your pain, working with your doctor and being open to a variety of treatments will help you manage your pain and improve your quality of life.

Pain, which follows from broken bones or traumatic injury can typically be treated effectively by doctors. Often, opiate based medicines such as morphine are used during the acute phase of recovery. While effective, these medicines are strong and can contribute to constipation. Typically, your doctor will want to reduce these medicines as your pain naturally declines over time - this can include medicines such as paracetamol and ibuprofen. While these are often thought of a medicines one takes for a sore head, they are actually very good at managing moderate pain which follows from trauma.

More information on the types of medication the doctors prescribe for pain can be seen in the Medications section.

There is another type of pain which can occur after spinal injury called neurogenic pain or neuropathic pain. These two terms can be used interchangeably and sometimes people will use the less specific term, nerve pain.

Neurogenic pain ("neuropathic pain") is caused by abnormal communication between the nerves that were damaged by your spinal cord injury and the brain. In neurogenic pain, it is thought that the brain "misunderstands" or "amplifies" the signals it receives from the damaged nervous system. This can cause you to experience pain coming from areas of your body below where you have little or no feeling. This is why a person can feel neurogenic pain in an area that otherwise has no feeling. It is often compared to phantom pain that patients suffer after amputation.

While pain caused by trauma can be treated effectively, neuropathic pain can be more challenging to treat. If your medical consultant thinks you may have neuropathic pain, they will often try medicines that are known to help. These medicines are called tricyclic antidepressants or anti-epileptic drugs. These are the most effective medications we have for neuropathic pain and work by dampening down the nervous system. Often, the medications are helpful at soothing the intensity of the pain but may not switch it off entirely. This is often frustrating for individuals and there are often limits as to how much medication can be given. More is not necessarily better as some of the medicines used for neuropathic pain can make people unduly sleepy and impact upon rehabilitation.

For some people following spinal injury, the pain they experience can become a long term condition that they will have to manage. While an individuals focus on pain management in the acute phase is often on medication, the passage of time often sees people explore alternative treatments, appreciate broader psychosocial factors such as activity levels and stress, and slowly get on with valued activities despite any ongoing pain.

Pain is not only managed by medication but by several other methods including transcutaneous electrical nerve stimulation, acupuncture, and psychological approaches.