Management of pain problems

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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

This involves:

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

Visceral (internal organ) 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.