Self-Inflicted Finger Injury in Individuals With Spinal Cord Injury: An Analysis of 5 Cases

This paper describes five cases of finger biting and self-mutilation in people with spinal cord injuries resulting in complete paralysis of all four limbs (tetraplegia). The study explores potential causes and treatments for this behavior. Researchers investigated whether the behavior was linked to pain, anxiety, or obsessive-compulsive traits. They found no consistent link to pain in the affected areas, and obsessive-compulsive traits were generally mild. The study suggests the behavior might be an extreme form of nail-biting triggered by sensory deprivation and social isolation, combined with a lack of sensation in the fingers due to paralysis. Treatments like medication, counseling, and behavioral therapy had mixed success.

• 1
  Pain in the targeted limb was reported in only 1 of 5 patients, suggesting that self-injurious behavior was not primarily driven by pain in the affected area.
• 2
  Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal among the patients, indicating a potential link between pre-existing habits and self-injurious behavior after spinal cord injury.
• 3
  The group exhibited heterogeneous medical, social, and cultural characteristics, indicating that there is no single cause for self-injurious behavior in individuals with tetraplegia.