title: Living with chronic neuropathic pain after spinal cord injury: an interpretative phenomenological analysis of community experience.
abstract: OBJECTIVE
  This article presents an in-depth, idiographic study examining the lived experience of chronic pain following spinal cord injury (SCI). Neuropathic pain (NP) occurs in a large majority of the SCI population and is particularly intractable to treatment. It can be both psychologically and physically debilitating. This study examines how the experience of NP is mediated by its meaning to the sufferer.
  
  
  METHODS
  Semi-structured interviews were conducted with eight people with SCI and chronic NP, attending outpatient clinics at a specialist SCI Centre in the UK. Verbatim transcripts were subjected to interpretative phenomenological analysis to further understand the experience.
  
  
  RESULTS
  Analysis suggested that NP has powerful consequences upon the sufferer's physical, psychological and social well-being, in line with a biopsychosocial understanding of pain. Three super-ordinate themes were identified: a perceived gap between treatments received and participants' views of what they wanted and needed; a fight for life control and acceptance; and feeling understood by others with SCI, but isolated from the non-understanding able-bodied.
  
  
  CONCLUSIONS
  The results are discussed in terms of the possible application of acceptance-based therapy to NP and the potential for the alleviation of the debilitating consequences of NP.
  
  
  CONCLUSIONS
  Chronic NP after SCI is often described as worse than the injury itself, often impacting upon the sufferers physical and psychological health. The experiences of persons with SCI-specific NP highlight the impact of pain on their physical, psychological and social health. This indicates that healthcare professionals should incorporate a biopsychosocial approach for managing pain post-SCI. Routine clinical follow-up of SCI patients with chronic NP, as well as comprehensive pain management treatment programmes, could address the three themes evidenced in the current study, by moving routine intervention with NP away from pain relief, towards pain management. Continued education for patients, friends, family members and healthcare professionals may be beneficial in promoting understanding and awareness of NP and its consequences following SCI.
authors.affiliation: a Department of Psychology , The University of Buckingham , Buckingham , UK and.
authors.forename: Jasmine H
authors.initials: JH
authors.lastname: Hearn
authors.affiliation: b Department of Clinical Psychology , The National Spinal Injuries Centre, Stoke Mandeville Hospital , Aylesbury , UK.
authors.forename: Imogen
authors.initials: I
authors.lastname: Cotter
authors.affiliation: a Department of Psychology , The University of Buckingham , Buckingham , UK and.
authors.forename: Philip
authors.initials: P
authors.lastname: Fine
authors.affiliation: a Department of Psychology , The University of Buckingham , Buckingham , UK and.
authors.forename: Katherine
authors.initials: K
authors.lastname: A Finlay
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D009437:Neuralgia / Q000209:etiology / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement / Q000523:psychology; D010351:Patient Discharge; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000628:therapy*
keywords: Acceptance; biopsychosocial; pain; pharmacological treatment; social isolation; spinal cord injury