The relationship between pain and mood following spinal cord injury

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2016.1147680 · Published: May 1, 2017

Spinal Cord Injury Mental Health Pain Management

Simple Explanation

Spinal cord injury can significantly impact a person’s physical, functional, and psychological well-being, with pain being a common and debilitating issue. It's estimated that around 65% of individuals with SCI suffer from chronic pain. The psychological impact of SCI is also significant, with approximately one-quarter to one-third of people with SCI experiencing significant levels of depression following their injury. Pain and mood are interconnected, creating a complex relationship. This study supports the idea that pain and mood influence each other, creating a cycle where pain can worsen mood, and low mood can intensify pain. Addressing both pain and psychological issues early in rehabilitation is crucial for optimizing patient outcomes.

Study Duration

February 2008 and February 2015

Participants

509 patients who completed both Needs Assessment Checklist (NAC) 1 and NAC2

Evidence Level

Retrospective cohort study

Key Findings

1
Significant improvements were observed in both pain and mood from the initial assessment (NAC1) to the pre-discharge assessment (NAC2).
2
There were significant correlations between pain and mood at both assessment points, indicating that a decrease in pain was associated with an improvement in mood.
3
Individuals who reported that pain interfered with their rehabilitation had higher pain scores and lower mood scores at both assessment points.

Research Summary

The study explored the relationship between pain and mood during spinal cord injury rehabilitation, finding significant correlations between the two. Improvements in pain were associated with improvements in mood, and vice versa. The research supports the bidirectional causality hypothesis, suggesting that pain and mood exert an effect upon each other. Addressing both early in the post-injury phase can optimize rehabilitation outcomes. The results highlight the importance of early and integrated management of both pain and psychological issues during SCI rehabilitation to improve patient recovery and overall outcomes.

Practical Implications

Early Assessment

Implement early and frequent assessments of both pain and mood to identify potential issues and tailor interventions effectively.

Integrated Treatment

Adopt an integrated approach that combines psychological and pharmacological interventions to address both pain and depression simultaneously.

Biopsychosocial Model

Treat pain within the context of the biopsychosocial model, considering the interaction of biological, psychological, and social factors.

Study Limitations

1
The study only assesses one aspect of pain.
2
There is a need for further research to examine what other factors are involved and to further explore this complex relationship.
3
Future research may wish to further analyze the relationship between pain and mood, starting earlier post-injury and utilizing more time points and a variety of different pain and mood measures, to clarify the nature of this relationship and how it develops longitudinally.

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