The influence of pain on community reintegration after spinal cord injury

Pain Practice, 2025 · DOI: 10.1111/papr.13439 · Published: January 1, 2025

Spinal Cord Injury Pain Management Public Health

Simple Explanation

Spinal cord injuries can cause loss of motor and sensory function and lead to secondary health conditions like pain which can affect daily living. Pain is a common problem, affecting 70% of individuals with SCI, and can lead to depression and poor sleep. This study looked at how pain affects community reintegration in people with spinal cord injuries who use manual wheelchairs. Community reintegration involves regaining life roles, maintaining relationships, and finding a sense of purpose. The study found that the severity and location of pain, particularly shoulder pain, influenced community reintegration. Managing shoulder pain and neuropathic pain is important for helping people with SCI reintegrate into their communities.

Study Duration

February 2019 to March 2020

Participants

122 manual wheelchair users with SCI

Evidence Level

Not specified

Key Findings

1
Most participants (85.2%) reported current pain, with neuropathic pain (53.3%) being more common than nociceptive shoulder pain (14.8%).
2
There was no significant difference in overall community reintegration between participants with and without pain.
3
Severity of pain, especially shoulder pain, was negatively associated with taking trips out of town and overall community reintegration.

Research Summary

This study investigated the influence of pain on community reintegration among manual wheelchair users with spinal cord injury (SCI). It examined the associations between neuropathic pain, nociceptive pain, pain severity, and community reintegration. The study found that the presence of pain alone did not significantly influence community reintegration. However, the severity and location of pain, particularly shoulder pain, were negatively associated with specific aspects of community reintegration, such as taking trips out of town. The authors concluded that managing pain, especially shoulder and neuropathic pain, is crucial for optimizing the rehabilitation and community reintegration of individuals with SCI.

Practical Implications

Shoulder Pain Management

Implement strategies to minimize shoulder load and address shoulder pain with self-management techniques and education on shoulder care.

Neuropathic Pain Assessment

Assess neuropathic pain in relation to specific activities and manage it adequately to improve community reintegration outcomes.

Individualized Rehabilitation

Consider individual needs and perceptions of integration and participation to tailor rehabilitation programs effectively.

Study Limitations

1
The study only included participants with paraplegia, which may limit the generalizability of the findings to individuals with tetraplegia.
2
The small sample size of participants with shoulder pain may have influenced the results.
3
The surgical procedures reported by some participants with shoulder pain may have influenced WUSPI scores, and more information about the success and recovery of these procedures may have provided additional context.

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