The prevalence and association of neck (coat-hanger) pain and orthostatic (postural) hypotension in human spinal cord injury.
OBJECTIVE
To investigate the prevalence of orthostatic (postural) hypotension (OH) and neck pain in a 'coat-hanger' occipito-cervical distribution in subjects with spinal cord injury (SCI), and their association.


METHODS
Blood pressure was measured during head-up tilt to 60 degrees (to determine OH) and neck pain was assessed in 28 subjects with SCI (cervical, thoracic and lumbar level) with McGill Pain Questionnaire, visual analogue scale for pain intensity and Orthostatic Intolerance Symptoms Questionnaire for pain frequency.


RESULTS
Neck pain was reported by 53.6% of subjects. Orthostatic hypotension was present in 57.1% of subjects. Neck pain was reported by 75% of subjects with OH and 25% of subjects without OH (P<0.03, Chi-square). Features of such pain included positive correlation to upright posture and exercise, and relief when lying flat.


CONCLUSIONS
There is a high prevalence of neck pain and OH in SCI, with a positive association similar to that reported in primary autonomic failure with OH.
Cariga
P
P
Neurovascular Medicine Unit, Imperial College at St. Mary's Hospital, London, UK.
Ahmed
S
S
Mathias
C J
CJ
Gardner
B P
BP
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology* / Q000209:etiology*; D010147:Pain Measurement; D015995:Prevalence; D013119:Spinal Cord Injuries / Q000150:complications*