How to manage pain after a Spinal Cord Injury

A common symptom after a spinal injury is pain. Messages are sent interchangeably from our brain to our body through our spinal cord. After a spinal cord injury, those messages passing through the spinal cord are interrupted. The brain is not receiving accurate information and interprets it as pain. In addition, secondary complications arise due to constant wheelchair use and bladder problems. This article will go over the types of pain experienced and how to manage them effectively.

Every spinal cord injury is unique, so everyone will experience pain differently. Pain can be intermittent or constant and mild to severe. Understanding the symptoms of the specific types of pain will help you communicate your pain more effectively with a healthcare provider.

The most commonly reported types of pain after spinal cord injury

1. Musculoskeletal pain

Musculoskeletal pain is often described as, “dull and consistent but bearable.”

This type of pain can be attributed muscle tightness due to excessive use of muscles and joints or due to poor posture, which pulls the muscles and strains the joints.

After an spinal cord injury, you may become more dependent on the unaffected parts of your bodies. These muscles may not be accustomed to doing so much work so musculoskeletal pain may develop.

For example, someone with paralysis in their legs will have to learn to rely upon their shoulders and arms to move around in a wheelchair. Consequently, the patient may experience pain in the shoulders, elbows, wrists, and forearms as a result of overuse.

It’s interesting to note that musculoskeletal pain is typically felt above the injury site, where sensation is not affected.

2. Visceral pain

Visceral pain refers to pain from internal organs. Although it’s the least common pain, it can be the most long-lasting. This type of pain generally occurs around the abdomen in the form of aching or cramping. Many patients with spinal cord injury have difficulties controlling their bowel and bladder muscles, which can cause constipation and urinary tract infections. Therefore, it makes sense that visceral pain often occurs after spinal cord injury.

3. Neuropathic pain

Neuropathic pain is directly due to the damage to the spinal cord. The signals from the body to the brain are misinterpreted as pain due to the damage at the spinal cord.

Neuropathic pain can be described as “sharp, stabbing, or burning” pain that can be felt below the level of injury, even in areas where you have lost sensation.

Now that you understand types of pain that can occur after a spinal cord injury, let’s discuss how to manage them.

5 ways to manage your pain effectively

1. Medication

Medications for pain after spinal cord injury will vary depending on the severity of pain.

Commonly used medications for pain include:

• Non-steroidal anti-inflammatory drugs (NSAIDs)

• Muscle relaxants

• Topical numbing creams

• Opioids

• Antidepressants

• Anticonvulsants

Medications can be extremely helpful, but they generally will not address the source of pain. As a result, pain reduction is often temporary, and medications may not be ideal for long-term relief.

2. Physiotherapy

Physiotherapy can help reduce pain after spinal cord injury by strengthening underused muscles, lengthening tight muscles, and promoting the full range of motion in the joints. By continuously practicing exercises, spinal cord injury patients can stimulate neuroplasticity.

Neuroplasticity is the spinal cord’s ability to make new connections from the body to the brain. The muscles and sensations experienced after the spinal cord injury can be strengthened and improved. Repetitive movement can reduce the excitability of spastic muscles and help reduce pain long term.

3. Botulinum toxin

Botulinum toxin injections can be an effective way to minimize pain in muscles affected by spasticity. Instead of taking an oral medication that will affect the entire body, botulinum toxin is injected directly into the affected muscle. It works by blocking transmitters that cause muscle contractions. The effects of botulinum toxin typically last between 3-6 months. Intensive Physiotherapy is crucial during this period as it will focus on promoting new connections. These connections will then ensure long-term pain relief from the muscles affected by spasticity.

4. Electrical stimulation

Electrical stimulation is used to promote movement and reduced pain after spinal cord injury. The electric currents block pain signals and stimulate release of endorphins. Stronger electric currents promote movement and help strengthen muscles. This will help reduce underused muscles and target spasticity.

5. Orthotics

If you are experiencing pain from poor positioning of joints due to your spinal cord injury, wearing orthotic devices such as braces, splints, and casts may promote passive movement. This will reduce stiffness and strain on joints.

Living with pain after spinal cord injury can disturb your daily activities, mental health, and relationships. As described in this article, there are effective ways to minimize pain to continue your recovery and improve your overall well-being. Everyone experiences pain after the spinal cord differently, so treatments will vary from person to person. When visiting your healthcare professional about your pain, try to be as descriptive as possible. Answering questions like; whether it is constant or intermittent, what makes the pain worse, and what makes the pain better. Feel free to contact At Home Rehab for a consultation regarding pain following your spinal cord injury.