Pain in a spinal cord injury (SCI) can be complicated and
confusing. There are different types of pain, and they are often described in
different ways. You may feel pain where you have feeling. But you may also feel
pain in an area where otherwise you have no feeling. The pain may be severe at
some times. But at other times it may disappear or bother you only a little.
The most common type of pain experienced with SCI is neuropathic
pain around the injury area. This is also known as the “circle of fire” or the
“ring of fire.” Neuropathic pain is caused by damage to the nervous system.
Other types of pain include musculoskeletal (pain in the bones, muscles, and
joints), and visceral (pain in the abdomen).
Neuropathic pain is caused by
damage to the nervous system. It is common in SCIs.
Spinal cord injury (central) pain occurs in
areas where you have lost some or all of your feeling. It is not related to
movements you make or to your position. It is often described as tingling,
numbness, or throbbing. This is sometimes called “the circle of
Segmental pain often occurs around the “border” between
where you have feeling and do not have feeling.
entrapment pain occurs at or just below the level of injury. It results in
brief instances of sharp pain or burning pain where your normal feeling stops.
Even touching the area lightly may make the pain worse.
Musculoskeletal pain occurs in
the bones, joints, and muscles. Unlike neuropathic pain, movement affects it,
and it is usually made worse by movement and eased with rest. It is often
described as a dull or aching pain.
Secondary overuse pain is caused by the overuse
of muscles in any part of the body. In people with an SCI, this often occurs
because one muscle group is always used. For example, it may develop in the arm
or shoulder as a result of pushing a manual wheelchair.
spasm pain is painful involuntary movements (spasms) of a body part that you
cannot move or can only partially move. The pain is caused when muscles and
joints are strained.
Visceral pain occurs in the abdomen
(stomach area). The pain can be described as burning, cramping, and constant.
If you have pain, do not ignore it. Talk
to your doctor. You need to know the type of pain and its cause to manage it.
And pain can signal a more serious problem.
Complementary therapies may reduce pain. They may also help you
cope with stress and improve your emotional and physical well-being. These
Acupuncture, a treatment based on
traditional Chinese medicine. Acupuncture involves putting very thin needles into the skin at certain points on the body.
Biofeedback, a method of consciously controlling
something normally controlled automatically by the body, such as skin
Guided imagery, a series of thoughts
and suggestions that direct a person’s imagination toward a relaxed, focused
Hypnosis, a state of focused concentration. In
hypnosis, a person becomes less aware of his or her surroundings. Some people
learn to manage pain by concentrating in this way.
Yoga, which uses meditation and exercise. Yoga helps
you improve your breathing, be more flexible, reduce stress, and stay
Counseling (such as cognitive-behavioral therapy) focuses on your mental
health and conditions such as stress and depression. These can happen along with chronic pain
and make it worse. To recover from your chronic pain, it is important to take
care of your emotional health and your physical health.
classes of medicines are used for neuropathic pain. These include anticonvulsants (such as
gabapentin) and tricyclic antidepressants (such as amitriptyline).
Segmental pain may also be treated by
injecting an anesthetic medicine into the space between the wall of
the spinal canal and the covering of the spinal cord (epidural block) or with surgical procedures that cut nerve roots.
ByHealthwise Staff Primary Medical ReviewerAdam Husney, MD – Family Medicine Martin J. Gabica, MD – Family Medicine Kathleen Romito, MD – Family Medicine Specialist Medical ReviewerNancy Greenwald, MD – Physical Medicine and Rehabilitation