Management of pain problems
Manage a problem ‘just-in-time’
Serious complications can arise if pain-related problems are not managed in a timely way.
In the long term, these issues can lead to:
- Physical deconditioning and reduced activity levels
- Interference with your mood and sleep
- Increased reliance on medications
- Resorting to unhelpful or destructive strategies, such as taking illicit drugs or excess alcohol
- Social withdrawal.

‘Just-in-time’, or the right care at the right place at the right time, helps you manage your pain. As a result you will maintain your quality of life, independence, health and wellbeing.
Be proactive and take responsibility for managing your own health risks
- Education to help you understand how your spinal cord injury affects your pain perception and learn about the latest research findings.
- Becoming a partner in decision-making and learning to problem solve with your doctor and health professionals.
- Developing an individual pain self-management program that works for you.
- Engaging in ongoing health and wellness activities. This includes:
- Exercising regularly
- Maintaining a healthy weight to reduce load on your shoulders, arms and hands
- Using medications as instructed by your doctor
- Incorporating regular relaxation, meditation and mindfulness techniques into your daily life.
Nature of pain
Pain can be acute or chronic in nature

Acute pain
Pain that occurs immediately after an injury, disease or surgery. Acute pain can be severe, but usually gets better within about 3 months as the body heals itself from the trauma.
Acute pain is important for our survival because it helps to protect us from danger.

Chronic pain
When pain persists for longer than 6 months, we reclassify it as chronic pain. There are different mechanisms that generate and maintain chronic pain.
Chronic pain can be present even after injured tissues have healed.
Important notes
Chronic pain is different to acute pain. Chronic pain responds differently to treatments for acute pain. In fact, treating chronic pain the same way you treat acute pain doesn’t work.

Pain can be categorised as follows: Nociceptive pain and Neuropathic pain.
Nociceptive pain arises from tissue damage that is sensed by specific pain receptors, called nociceptors. There are several different types of nociceptive pain:
- Musculoskeletal pain, e.g., shoulder pain
- Visceral pain from internal organs, e.g., abdominal pain
- Other nociceptive pain, e.g., autonomic dysreflexia headache.
Neuropathic pain arises due to direct damage to the spinal cord and nerves resulting in:
- At-level neuropathic pain, e.g., band-like pain felt at level of spinal injury
- Below-level neuropathic pain, e.g., pain well below spinal level in your legs
- Other neuropathic pain, e.g., carpal tunnel syndrome due to median nerve compression at the wrist.
Common types of pain
What does research tell you?
Pain can be categorised as follows: Nociceptive pain and Neuropathic pain.
Nociceptive pain arises from tissue damage that is sensed by specific pain receptors, called nociceptors.
There are several different types of nociceptive pain:
- Musculoskeletal pain, e.g., shoulder pain
- Visceral pain from internal organs, e.g., abdominal pain
- Other nociceptive pain, e.g., autonomic dysreflexia headache.
Neuropathic pain arises due to direct damage to the spinal cord and nerves.
Neuropathic pain can result in:
- At-level neuropathic pain, e.g., band-like pain felt at level of spinal injury
- Below-level neuropathic pain, e.g., pain well below spinal level in your legs
- Other neuropathic pain, e.g., carpal tunnel syndrome due to median nerve compression at the wrist.

Musculoskeletal pain is more prevalent in people with spinal cord injury who:
- Are older (aged over 60 years)
- Have been injured for less than 5 years or more than 20 years.

84%
of individuals reported pain as an issue
Did you know?
It is normal for pain to fluctuate in intensity during the day or from one day to the next. However, when pain suddenly intensifies or the location or characteristics change, it needs to be checked out.
Musculoskeletal pain
Musculoskeletal pain refers to conditions affecting muscles, bones and joints.
Pain location: It is common to feel pain in an area where the nerves have not been damaged, either above the level of your spinal cord injury or below the level, if you have an incomplete injury with preserved sensation.

Pain description:
Dull, sharp, tender, aching.
Things that make pain worse:
Certain body positions or movement, such as lifting to transfer, driving, pushing a wheelchair, exercise or sport.
Things that reduce the pain:
Rest, changing position, certain medications, and equipment changes.
Common types of musculoskeletal pain are shoulder pain, wrist arthritis, neck or back ache and muscle spasms.
Visceral (internal organ) pain
Pain location:
Abdomen, chest or pelvis.
Pain description:
Dull, cramping, aching, colicky (experiencing severe pain in the abdomen), comes and goes, poorly localised.

Things that make pain worse:
Bladder infection, bladder/kidney stones, constipation, gall stones, heartburn or
acid reflux.
Things that reduce the pain:
Treating infections with antibiotics,
adjusting your bowel regime to allow
for proper emptying.
Causes of visceral pain include:
Bloating, constipation, cramping and
bladder infection.
Neuropathic pain
Neuropathic pain refers to pain caused by damage or disease affecting the nervous system.
Pain location:
It is common to feel neuropathic pain at the level of your spinal cord injury and/or below the level of your spinal cord injury in an area of abnormal or absent sensation. Nerve pain may also occur above the level of your spinal cord injury due to direct nerve compression at your wrist or elbow from pressure and overuse. Pain may be felt in the feet, legs, buttocks, abdomen, trunk, hands, arms and shoulders, depending on the level of your spinal cord injury.
Pain description:
Hot, burning, shooting, stabbing, electric shocks, icy/cold, squeezing, constricting, crawling, tingling or pins and needles.
Things that make pain worse:
Bladder infection, constipation, fatigue, stress.
Things that reduce the pain:
Medications, being distracted, gentle exercise.