Spinal Cord Injury (SCI): Managing Pain

Pain is a common problem when you have a spinal cord injury (SCI). Changes in neurotransmitters and the nervous system itself are common. When pain isn't controlled, it can limit what you can do and reduce your quality of life. Try not to focus on your pain but pay attention when you're uncomfortable. Check your limbs and posture and see if a change in your position helps. Pain can be your clue that something is wrong. If you notice a change in pain levels, let your care team know. They can advise changes in your treatment plan as needed. They can also teach you skills to help you cope. Managing your pain as well as possible helps you remain active and care for yourself to the best of your ability.

With an SCI, you're more likely to have certain types of pain. These can include:

• Pain from damaged nerves. This often occurs at the site of your injury or the area just around it or below it. It may cause numbness, tingling, burning, or sharp, stabbing pain.
• Pain from the spinal cord or brain. This is felt below the level of injury, including areas where there is reduced or no sensation. The pain may feel like burning, tingling, freezing, or a brief jolt or shock.
• Pain in your muscles, joints, or bones. This type of pain may be caused by physical damage at the time of your injury, wear and tear from aging or arthritis, or muscle overuse. The pain may feel like dull aching or throbbing. You may also have inflammation and muscle spasms.
• Pain from your internal organs. This may be felt in your belly (abdomen) or chest. It is often caused by problems in your stomach, gallbladder, or bowels. You may have symptoms such as cramping, bloating, or constipation.

Pain can and should be treated. Tell your care team about any pain that you are having. And work with your team to explore choices for managing your pain, and balance benefits versus side effects. The best choices for you depend on the type, severity, and cause of your pain. These may include:

• Medicines, such as NSAIDS (non-steroidal anti-inflammatory drugs), muscle relaxants, anticonvulsants, antidepressants, and opioids (narcotics).
• Physical therapy, occupational therapy, exercise, wheelchair assessment, and activity modifications.
• Nerve stimulation treatments, such as transcutaneous nerve simulation or spinal cord stimulation.
• Surgery, such as placement of a pump to deliver pain medicine or antispasticity medicine directly to the spinal cord.
• Medical marijuana and cannabis products. (Availability depends on local laws.)

Many people with an SCI also report being helped by treatments, such as:

• Relaxation and meditation.
• Distraction, visualization, and positive thinking.
• Controlled heat.
• Acupuncture.
• Biofeedback.
• Hypnosis.
• Massage therapy.

Staying healthy can also help reduce your risk of other problems and make it easier to cope with pain. Follow the guidelines you have been given for eating and exercising. Get enough sleep. Limit harmful habits, such as drinking and smoking. And see your care team for regular follow-up visits. They are there to help you live healthy and well.