Pain and spinal cord injuries
Some people experience pain after a spinal cord injury. This can be acute, where it is felt for a short period whilst the body heals. Or, it can last for a longer time after healing and be referred to as chronic.
Pain is often categorised as follows: Musculo-skeletal pain, which is from injuries or problems with bones, muscles, tendons, ligaments or joints. Visceral pain, which is from injuries or problems with the gut or organs. And, neuropathic pain, which is felt due injury or damage to the nerves, including the spinal cord itself.
How can a spinal cord injury affect pain?
The spinal cord contains neurons, which send messages between nerve cells. Some neurons have the job of blocking pain messages that travel to the brain. A group of these neurons in the spinal cord form a gate and can control whether pain messages are blocked, let through, or partly closed. When the spinal cord is damaged, the neurons can also become damaged and they cannot work the gate. This can result in an increase in pain messages reaching the brain. It can also become sensitised to pain messages, turning the volume up on the pain, which can make even light touch be painful for some people.
What opens pain gates in the brain?
• Negative or unhelpful thoughts (e.g. “this is never going to get any better”, “I’m useless”)
• Low mood/depression
• Focusing all your attention on the pain
• Inactivity (doing very little)
• Over doing it and not pacing activity well
• Prolonged use of certain drugs. The use of illicit drugs, or using certain types of prescribed medication (e.g. opiates) at too high a dose, can open pain gates and make more pain messages get through.
What closes pain gates in the brain?
• Medication – can reduce hypersensitivity
• Exercise and stretching to reduced muscle stiffness and release endorphins
• Thought challenging
• Meditation and relaxation
• Distraction/ focussing on activities that you value and enjoy
Other helpful techniques to manage pain:
• Trying to get into a good sleep pattern, getting the right amount of sleep for you.
• Rest – making sure you take regular rest as fatigue may be more likely following spinal cord injury.
• Pacing plan – having a good plan for pacing your activity so that you don’t over-do it.
Talk to the ward psychologists about pain management.