Understanding and managing pain

For many, living with spinal cord damage means managing and treating pain quite regularly. Everyone experiences pain differently, and management techniques can vary in their success for each person. You can feel pain in areas of your body even if you have no movement or sensation. Likewise, pain can occur in areas of your body where you do have movement and sensation. It can range from sharp, burning sensations to mild discomfort. Of course, please speak to your doctor before making any decisions about your pain management.

Types of pain

Acute
Occurs after the onset of a spinal cord injury. It can include damage to bones and muscles at the time of injury.

Chronic
This pain lasts for months or years and can be difficult to treat.

Musculoskeletal
Often described as a dull or aching pain, caused by damage to the musculoskeletal structures such as bones, ligaments, muscles and joints. It’s usually felt above the level of injury or in areas where feeling is preserved below the level of injury. Examples include spinal fractures, muscular injury, shoulder spins or shoulder overuse syndrome.

Root
Root pain comes from nerve ends that have been damaged. Root pain can often be described as ‘phantom’ pain and can come from parts of your body where there is no sensation.

Visceral
This pain is related to internal organs, usually in the thorax and abdomen. It is described as dull, aching or cramping with a common example being a urinary tract infection or bowel impaction.

Hypersensitivity
This type of pain occurs on areas of your body that still have sensation. The increased sensitivity to this pain occurs when the body overcompensates for the loss of feeling elsewhere by becoming extremely sensitive. A person with hypersensitivity pain can feel intense pain from the smallest movements or touch

Neuropathic
Often described as a tight band at the level of injury and can be caused by nerve root compression, for example cauda equina, syringomyelia and spinal cord damage. Below the level of injury where feeling is absent or impaired you may feel pain not necessarily to the structure generating the pain, such as burning buttock pain.

Aches & Pains
Aches and pains often occur around your level of impairment. Often, these pains are caused by the original damage to your spinal cord and the resulting surgeries. Aches and pains can also result from stiffness or spasticity to joints and limbs, as well as general wear and tear, or arthritis in your joints.

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Common treatments

Painkiller and Nerve Pain medication
Painkillers are often seen as the traditional method for treating chronic pain. Unfortunately, many types of pain do not respond well to painkillers. They are not considered adequate as a long-term treatment due to the addictive nature of many of the medicines used. Always consult your doctor before using any medications and as always, do not share other medications.

Nerve Stimulation
Nerve stimulation treatments follow a similar principle as acupuncture but instead use small electrical ‘shocks’ to interrupt the pain signals. This form of treatment is commonly applied externally using electrodes on the skin. More advanced procedures will apply the stimulation directly on the nerve with an implant. This treatment could be considered if you have poor outcomes with medication.

Surgical interventions
Surgical procedures are sometimes used to ‘clean up’ damaged areas in the body to relieve pressure on damaged nerves. This procedure is considered ‘riskier’ and needs to be carefully assessed with your doctor.

Adjunct Therapies and Strategies
There are several approaches to employ that can assist outside of medication:

• Pacing – Breaking down activities into components or sections with allocated rest periods in between
• Prioritising – Deciding what is important and delegating activities that are not crucial
• Avoiding ‘Boom and Bust’ – Having too much activity on one day which may exacerbate pain, requiring day/s of rest to compensate.

For newly acquired spinal cord injuries it can take time to understand how your body best responds to and manages pain. This will also be dependent on the type of spinal cord damage. If you are finding that you are in ongoing pain and unsure how to treat and manage it, please contact our Allied Health team who will be able work through this with you.

Contact us today to find out more.