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Quality of life after spinal cord injury: The impact of pain
Author(s) -
Burke D.,
Len O.,
Fullen B.M.
Publication year - 2018
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1248
Subject(s) - medicine , neuropathic pain , quality of life (healthcare) , spinal cord injury , physical therapy , confounding , nociception , brief pain inventory , pain catastrophizing , chronic pain , anesthesia , spinal cord , psychiatry , receptor , nursing
Background Pain is a common complication after spinal cord injury ( SCI ). A mixture of nociceptive and neuropathic pain ( NP ) can present. Limited studies have investigated the impact of different pain phenotypes on quality of life (QoL) post‐ SCI . Methods Members registered to a national support group for those with SCI s were surveyed ( n = 1574). The survey comprised questions relating to demographics and SCI characteristics, The Douleur Neuropathique 4 ( DN 4) (interview), the International SCI Pain Basic Data Set recording the worst pain and the World Health Organisation Quality of Life BREF ( WHOQOL ‐ BREF ). An ANCOVA model with post hoc analysis explored between group factors of pain type and intensity of pain categories on QoL, controlling for additional confounding variables. Significance was set p < 0.05. A linear regression explored whether pain intensity, type or interference best predicted QoL. Results The response rate was 41% ( n = 643), 70% ( n = 447) were male. The mean age of respondents was 52 years (SD 14.2) and mean time from SCI was 17 years (SD 12.4). In the previous week, 71% ( n = 458) experienced pain, 37% ( n = 236) of which had NP as defined in the study. Respondents experiencing NP demonstrated significantly poorer QoL than those without pain ( p < 0.001) or nociceptive pain ( p < 0.05). Those reporting high pain intensity had significantly lower QoL than those with moderate or no pain ( p < 0.001). Pain interference consistently and best‐predicted domains of QoL ( p < 0.001). Conclusion High‐intensity pain and NP negatively impacts QoL post‐ SCI . However pain interference more than intensity or type best explains the variance in QoL reported. Significance Neuropathic pain type and severe pain intensities negatively impact QoL after SCI . Pain interference items better predict reported QoL than either pain type or intensity, suggesting better pain management strategies are warranted.