"I don't know the correct way to describe it": neuropathic pain experiences among athletes with spinal cord injury

Background Chronic pain among athletes is often misinterpreted as tissue damage resulting from sport. While researchers have started to examine neuropathic pain among athletes with spinal cord injury (SCI), there is a need to develop a deeper understanding of their neuropathic pain symptoms and experiences, to support the development of evidence-based pain management protocols. Objectives The primary purpose of this study was to describe neuropathic pain experienced by athletes with SCI. A secondary purpose was to compare athletes' neuropathic pain symptoms when measured by two different clinical pain assessment tools and describe their experiences when trying to communicate their neuropathic pain. Methods 47 athletes with SCI completed the International Spinal Cord Injury Pain Basic Data Set (V.2.0), Douleur Neuropathique 4 (DN4), and two open-ended pain questions over the telephone. Results 66% of participants reported experiencing moderate-intensity neuropathic pain (M-pain intensity=5.32 +/- 1.78) and mild-to-moderate pain interference with activities of daily living (M-pain interference=3.55 +/- 2.11) and sleep (M(pain interference)4.68 +/- 2.92). Overall, participants reported significantly more neuropathic pain symptoms in response to DN4 questions (M=4.62 +/- 1.38) versus open-ended pain questions (M=2.13 +/- 1.08), p<0.001. Participants reported difficulty with identifying neuropathic pain, describing their pain symptoms and identifying pain locations. Conclusion Athletes with SCI reported moderate-intensity neuropathic pain. However, they struggled with communicating their neuropathic pain without being prompted with a list of symptoms. To guide the development of effective pain management strategies among athletes with SCI, future research should focus on developing knowledge products to improve awareness of common neuropathic pain descriptors among athletes with SCI and sports medicine personnel.