Pain is a very real and unfortunately very common side effect of a spinal cord injury (SCI). Although there are many degrees and variations of pain, it is likely you will experience it in some form or other. This can be debilitating and challenge your attempts to normalize your life after SCI, however, there are ever-developing methods of pain relief, as well as new and improved options for managing pain in the future.
What is Neuropathic Pain?
This kind of pain, otherwise known as neurogenic pain, is caused by abnormal communications between the brain and the nerves damaged by a spinal cord injury. Normal transmissions from the body through the spinal cord are misunderstood by the brain, thus creating the experience of pain from the site of injury and below (even in locations with little to no sensation or feeling).
Although that body part may not actually be painful, the feeling of pain remains real and so this can be a frustrating symptom to bear. This complex and often chronic pain starts days to weeks following the injury and is often described by individuals as shooting pains, with burning or stabbing sensations.
Types of Neuropathic Pain
- Segmental pain is a band-like pain, around the trunk of the body and sometimes within the arms. It is associated with allodynia and hyperalgesia. Allodynia is pain caused by something that does not usually cause pain, such as mild temperatures or something light to the touch. Hyperalgesia is an extremely painful response to what is normally only mildly painful. This type of pain is usually remedied with medications.
- SCI pain is the pain experienced below the level of injury, but can be felt over the whole body. It is made worse by a variety of conditions, such as spasticity, pressure sores, or stress.
- Radicular pain is often difficult to distinguish from pain caused by the actual injury. It is the result of nerve root damage and entrapment from broken bone or inflammation. Activity and movement can reduce this pain, which is often experienced on one side of the body only. Inflammatory medication can also provide some relief.
How is Neuropathic Pain Treated?
Neuropathic pain is one of the most difficult spinal cord injury offsets to treat. With each individual presenting very specific symptoms and pain, it can be hard to distinguish where the pain lies, and if it really is neurogenic or another kind of pain.
Medication is often prescribed, and there are a few forms which doctors have found help most in curbing and living with pain. Antiseizure medications are the most common, although these have side effects which include dizziness and sleepiness. Antidepressants and narcotics have been proven to work in some cases as well; however these carry risks of dependency and are to be used cautiously.
Surgical treatments are also available for neuropathic pain following an SCI. Dorsal column stimulators can be inserted into the spinal canal, and treat pain that is caused by nerve root damage. They emit high-frequency, low-intensity, nerve stimulating motions. Intrathecal pumps also treat this pain using morphine. These pumps are placed beneath the skin in the abdomen, delivering medication to the nerve roots.
