Eva Widerström-Noga, D.D.S., Ph.D. Research Professor, Department of Neurological Surgery and Physical Medicine and Rehabilitation, and The Miami Project, and colleagues, recently published Living with chronic pain after spinal cord injury: A mixed-methods study in the Archives of Physical Medicine and Rehabilitation. The purpose of the study was identify the relative importance of positive (facilitators) and negative (barriers) contributors to living with chronic pain after spinal cord injury (SCI). The research team used a mixed-method design combining individual semi-structured, open-ended interviews identifying facilitators and barriers, and measuring the agreement with these in a large online survey to determine relative importance and their associations with perceived difficulty in dealing with pain. Participants were people with SCI who experienced moderate to severe chronic pain.
Our analyses revealed 4 main facilitators (Information regarding pain and treatments, Resilience, Coping, and Medication use), and 5 barriers (Poor healthcare communication, Pain impact and limitations, Poor communication about pain, Difficult nature of pain, and Treatment concerns). The combination of greater impact of pain on life, the difficult nature of pain, poor communication with healthcare providers, having lower resilience, and greater medication use, and being younger was associated with having greater difficulty in dealing with pain.
This study revealed multiple facilitators and barriers to living with chronic pain after SCI. The main barrier, poor healthcare communication, suggest that consumers do not receive adequate information from their healthcare providers regarding pain. Information regarding pain and treatments, was perceived as being very important by the majority of participants and suggests that provider-patient communication and educational efforts regarding pain and pain management are priorities and critical needs. Further initiatives in these areas are important for improving pain management post-SCI.