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Pain after spinal cord injury (SCI)

Pain is a common and serious problem for people with spinal cord injury (SCI). It can occur both in areas with preserved sensation and in areas where sensation is reduced or absent. The pain is real and can significantly worsen quality of life, interfering with daily activities and rest.

For most people, the pain becomes chronic and can last for years. It is most often associated with damage to nerves, muscles, or joints. It is difficult to eliminate completely, but it is possible to reduce its intensity and learn to control its effect on life. Pain frequently intensifies anxiety, stress, and depression — and vice versa. This is an interconnected process, not a “psychological invention.”

Main types of pain

1. Neuropathic (nerve) pain

Arises due to damage to nerve structures. It may feel like burning, tingling, “electric shocks,” numbness, or stabbing pain. Sometimes pain occurs even with light touch. It often responds poorly to treatment, so a comprehensive approach is required.

If new or worsening pain appears years after the injury, especially along with changes in sensation, muscle strength, or spasticity, it is important to see a doctor — this may indicate another medical condition. Increased pain can also be triggered by constipation, urinary tract infection, or depression.

2. Musculoskeletal pain 

Related to muscle overload, joint problems, or spasms. It usually worsens with movement and decreases at rest.

Common complaints include:

  • pain in the shoulders, arms, and hands due to constant strain (e.g., when propelling a wheelchair or working at a computer);
  • pain in the back and neck;
  • painful muscle spasms and stiffness.

3. Visceral pain  

Originates from internal organs and may feel dull or cramping. It is sometimes accompanied by nausea. In people with SCI, symptoms can be atypical, so specialist evaluation is important. Referred pain is also possible — when discomfort is felt in a different area (for example, shoulder pain caused by gallbladder problems).

Treatment approaches

There is no single treatment method — a combination of different approaches is usually used.

Physical methods

  • changing movement techniques and daily activities;
  • physiotherapy and muscle-strengthening exercises;
  • massage;
  • acupuncture;
  • electrical stimulation (TENS, transcranial stimulation).

Psychological methods

These help reduce the impact of pain on life:

  • breathing techniques;
  • relaxation methods and biofeedback;
  • visualization and mindfulness;
  • self-hypnosis;
  • changing one’s relationship to pain (cognitive techniques);
  • psychotherapy.


Although pain after spinal cord injury can be complex, with the right comprehensive approach it can be significantly reduced and quality of life can be greatly improved.

 

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