Pain among veterans with spinal cord injury

The Department of Veterans Affairs Veterans Health Administration cares for approximately 15% of persons with spinal cord injury (SCI) in the United States. However, the nature and characteristics of pain among veterans with SCI are not well understood. This study used a postal Survey to compare veterans with SCI and nonveterans with SCI on pain intensity; pain interference; functioning; and other pain, demographic, and medical characteristics. Veterans tended to be older than nonveterans but these groups were otherwise comparable on demographic and medical variables. Veterans were not significantly different from nonveterans on pain intensity or pain interference. Veterans reported lower levels of functioning than nonveterans and higher levels of pain-related catastrophizing. However, differences in functioning between veterans and nonveterans were attributable to age differences between the groups. In summary, differences between veterans with SCI and nonveterans with SCI were few and small in magnitude, suggesting that veterans with SCI are not at greater risk for pain and pain-related problems. However, pain-related catastrophizing may be a particular concern among veterans with SCI.prevalence of chronic pain after SCI is more than 75 percent [1-3]. Persons with SCI consistently report average pain levels between 4 and 6 in studies using the 0-10 numerical rating scale (NRS) [4-5], pain levels that are high enough to warrant comprehensive treatment and prompt follow-up in primary-care settings [6]. Pain is severe, with a strong negative impact on daily functioning, in about one-third of persons with SCI [1-2]. Of significant concern is the finding that once pain conditions following SCI emerge, they tend to persist [3-4] or worsen [2,7] over time, despite the many efforts to treat this pain. In summary, while pain is a ubiquitous, recalcitrant problem among persons with SCI, the degree to which pain has a pronounced effect on functioning is much more variable. Developing a better understanding of subgroups of persons with SCI that may be especially vulnerable to pain-related functional disruptions is critical.