Pain Management Needs Holistic Approach
Spinal cord injuries (SCI) affect over 20 million people worldwide, with pain as a prevalent secondary condition that severely impacts quality of life. Researchers from NeuRA and UNSW Sydney have found that pain from SCI significantly affects psychological and social wellbeing, highlighting the importance of a comprehensive treatment approach.
The study, led by Dr. Negin Hesam-Shariati and Professor Sylvia Gustin, reviewed 78 studies involving nearly 20,000 participants. It identified a strong correlation between higher pain intensity and poorer psychological outcomes, such as distress and reduced social functioning.
Professor Gustin explained, “Pain is among the most common and disabling secondary health conditions following SCI, affecting approximately 50-80% of individuals and substantially contributing to long-term disability and reduced quality of life.”
Psychosocial Factors Influence Pain
The review highlighted that psychosocial factors, including mood and social context, can shape pain experiences. Dr. Hesam-Shariati noted that “the relationship people have with pain appears to change over time,” indicating the importance of psychological adjustment in long-term pain management.
Stuart Hurst, who experiences neuropathic pain post-SCI, stated that “medication helps, but it’s not the whole answer. The support I’ve had with my mindset and coping has been just as important.”
The findings advocate for a biopsychosocial approach to SCI-related pain, integrating biological, psychological, and social factors in treatment plans. This could include targeting depression, coping strategies, and social support within rehabilitation programs.
Further research is planned to develop integrated pain management methods and improve understanding of the interplay between pain and psychosocial factors over time. The Centre for Pain IMPACT is also conducting trials on new interventions for neuropathic pain, such as the NeurStim+ trial.
The systematic review and meta-analysis conducted included 78 studies, which reported associations between pain intensity and psychosocial factors in adults with chronic SCI. Dr. Hesam-Shariati stated, “Higher pain intensity was associated with greater fatigue, sleep disturbance, and anger, as well as lower self-perceived social functioning and quality of life and life satisfaction.”
The review also examined demographic and injury-related characteristics, including factors such as sex, age, time since injury, and tetraplegia. These factors influenced the associations, though the effects were limited and inconsistent. “We found that the relationship people have with pain appears to change over time,” Dr. Hesam-Shariati said. “Early after injury, people may be more likely to feel overwhelmed or distressed by pain, but over time, acceptance and psychological adjustment seem to become more important.”
