Chronic pain after spinal injury: interference with sleep and daily activities.
OBJECTIVE
To determine how chronic pain after spinal cord injury (SCI) interfered with sleep, exercise, work, household chores, and other daily activities and to define which clinical aspects of pain and psychosocial factors best predicted the extent of interference.


METHODS
Postal survey; follow-up to a previous survey conducted 6 months earlier.


METHODS
General community.


METHODS
Individuals (n = 217) with traumatic SCI and chronic pain.


METHODS
Subjects answered questions regarding frequency of interference caused by pain on 5 activities: sleep, work, exercise, household chores, and other daily activities. Asked to self-report sadness, fatigue, or anxiety; and to describe location, quality, and intensity of pain.


METHODS
Demographic data (gender, age, level of injury); sociodemographic data (education, employment); self-reported psychosocial outlook; clinical characteristics of pain: location (drawing), quality (descriptors), and intensity (2 numeric rating scales). Regression analysis.


RESULTS
The questionnaire was returned by 65.8% of the sample (217/330). A large number of the participants (77.3%) reported frequent interference caused by pain, ie, "often" to "always" in 1 or more of the 5 activities. The combination of high pain intensity and the use of multiple pain descriptors was significantly associated with frequent interference with falling asleep. Frequent sleep interruption was significantly associated with high pain intensity, male gender, anxiety, and higher age at time of injury. In working individuals, frequent interference due to pain was significantly associated with multiple pain descriptors, anxiety, low level of education, and being older at time of injury.


CONCLUSIONS
Reported extent of pain interference in various areas of activity is related to clinical symptoms of pain as well as to psychologic and psychosocial factors rather than level of injury. The relationship between frequent interference, pain intensity, and multiple descriptors indicate that individuals experiencing several types of pain of high intensity are more likely than others to experience frequent interference with a variety of daily activities including sleep.
Widerström-Noga
E G
EG
Miami Project to Cure Paralysis, FL, USA. ewiderst@miamiproject.med.miami.edu
Felipe-Cuervo
E
E
Yezierski
R P
RP
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D010148:Intractable Pain / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires