Predictive factors of chronic pain after spinal cord injury (SCI)

Background:

Chronic pain after SCI is a frequently reported condition with prevalence estimates ranging between 30 and 80%. Little is known about the predictors of chronic pain. Knowledge of these factors would allow for a more targeted approach in pain management.

Aim: To determine predictive factors for the reporting of chronic pain in people with SCI.

Methods:

A national self-report mail-in survey was completed by adults with SCI (N=627). Information included secondary health conditions, functional capacity, health behaviors, exercise status, community integration, self-efficacy, employment, injury level, age at injury and demographics. Bivariate and logistic regression analyses were performed with chronic pain as the dependent variable. Multicollinearity diagnostics were carried out.

Results:

Reporting chronic pain was significantly correlated (p≤ .05) with reports of depression, skin breakdown, ADL functioning, wheelchair use, smoking, community integration, unemployment and injury level. The logistic regression model included depression, wheelchair use, smoking, community integration and level of injury as predictors. The odds of reporting chronic pain after SCI are 2 and 2.5 times greater among those who report depression and those with lower level injury, respectively. Smokers and those reporting low levels of community integration also have significantly increased odds of reporting chronic pain. The model predicts with 62.8% accuracy and is a good fit (Hosmer-Lemeshow).

Conclusion:

While a causal relationship cannot be confirmed, the association between chronic pain and depression is well known from other populations. Their relative role along-side other variables in predicting community integration warrants further, especially prospective study.