Pain following spinal cord injury: the impact on community reintegration

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Abstract
Prospective, correlational. (1) Describe how pain changes over recovery from admission to spinal cord injury (SCI) rehabilitation, discharge and after 6 months of community living and (2) examine the relationship between pain and community integration at 6 months of community living. Tertiary rehabilitation centre, SCI unit, Vancouver, Canada. Subjects from 66 consecutive admissions to the SCI Program of a tertiary rehabilitation centre for the treatment of a traumatic SCI during the years 2000–2002 were followed using data from the National Rehabilitation Reporting System (NRS). Information was obtained from NRRS standardized assessments performed on admission, discharge and 6 months of community living. Early community living was defined as 6 months postdischarge. Community reintegration was assessed by the Reintegration to Normal Living Index (RNL). Pain presence, pain impact and pain intensity were assessed using single item Likhert-type scales. In all, 86% of individuals with a SCI reported pain at 6 months postdischarge, with 27% of these individuals reporting pain that impacted on many or most activities. Pain impact and pain intensity were related to the community reintegration (r=−0.39 and −0.55, P<0.001), with pain intensity accounting for 25% of the variance in RNL scores. Pain is a major consequence of a SCI, impacting on an individual's activities and perception of how well they are integrated into the community. The results of this study highlight the need to address pain during both the rehabilitation phase of treatment and the early transition into the community.