Pain Location and Functioning in Persons With Spinal Cord Injury

Background: The influence of pain location and extent on functioning in persons with spinal cord injury (SCI) and chronic pain is not well understood. Objective: To investigate the correlations between pain location and extent to determine which pain domains may be important to assess and potentially target in treating chronic pain in SCI populations. Design: Prospective, observational study. Setting: University medical center. Participants: A total of 259 persons with an SCI and chronic pain. Methods: Postal mail survey questionnaire. Main Outcome Measurements: Pain sites, pain extent (number of sites), pain intensity in specific body locations, pain interference, and physical and psychological functioning. Results: A positive association between pain extent and intensity with pain interference (r = 0.33, P < .01) and a negative association with psychological functioning were noted in the study sample (r = -0.21, P < .01). Pain intensity in the lower back and legs (r = 0.55, P < .01) and a number of other sites showed strong associations with patient functioning. Correlation with psychological functioning was significant but weaker (r = 0.22, P < .01 for the lower back and legs). Ambulatory status had only a small moderating effect on the associations between pain intensity in specific sites and pain interference and no effect on psychological functioning. Conclusions: The findings support the importance of assessing pain intensity at specific locations as a part of a thorough evaluation of chronic pain, as well as the importance of addressing pain at multiple sites, when managing pain in persons with an SCI.