Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 30:3:17083.
doi: 10.1038/s41394-017-0032-9. eCollection 2017.

Neuropathic pain in a rehabilitation setting after spinal cord injury: an interpretative phenomenological analysis of inpatients' experiences

Jasmine Heath Hearn  1 , Katherine Anne Finlay  2 , Philip A Fine  2 , Imogen Cotter  3
Affiliations

Neuropathic pain in a rehabilitation setting after spinal cord injury: an interpretative phenomenological analysis of inpatients' experiences

Jasmine Heath Hearn et al. Spinal Cord Ser Cases. .

Abstract

Study design: Qualitative, semi-structured interviews.

Objectives: Neuropathic pain (NP) can be psychologically and physically debilitating, and is present in approximately half of the spinal cord injured (SCI) population. However, under half of those with NP are adherent to pain medication. Understanding the impact of NP during rehabilitation is required to reduce long-term impact and to promote adherence to medication and psychoeducation recommendations.

Setting: United Kingdom.

Methods: Five males and three females with SCI and chronic NP, resident in rehabilitation wards at a specialist SCI center in the United Kingdom, took part. Semi-structured interviews were conducted with participants less than 15 months post-SCI (mean = 8.4 months). Verbatim transcripts were subject to interpretative phenomenological analysis (IPA).

Results: Three super-ordinate themes were identified, mediating pain and adherence: (1) the dichotomy of safety perceptions; (2) adherence despite adversity; and (3) fighting the future. Analyses suggest that experience of the rehabilitation setting and responsiveness of care shapes early distress. Attitudes to medication and psychosocial adjustment are relevant to developing expectations about pain management.

Conclusions: Enhancing self-efficacy, feelings of safety in hospital, and encouraging the adoption of adaptive coping strategies may enhance psychosocial and pain-related outcomes, and improve adherence to medication. Encouraging adaptive responses to, and interpretation of, pain, through the use of interventions such as coping effectiveness training, targeted cognitive behavioral pain management, and acceptance-based interventions such as mindfulness, is recommended in order to reduce long-term reliance on medication.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standardsThe authors declare that they have no competing interests.

References

    1. Kennedy P, Frankel H, Gardner B, Nuseibeh I. Factors associated with acute and chronic pain following traumatic spinal cord injuries. Spinal Cord. 1997;35:814–7. doi: 10.1038/sj.sc.3100569. - DOI - PubMed
    1. Modirian E, Pirouzi P, Soroush M, Karbalaei-Esmaeili S, Shojaei H, Zamani H. Chronic pain after spinal cord injury: results of a long-term study. Pain Med. 2010;11:1037–43. doi: 10.1111/j.1526-4637.2010.00865.x. - DOI - PubMed
    1. Bennett M. The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001;92:147–57. doi: 10.1016/S0304-3959(00)00482-6. - DOI - PubMed
    1. Siddall PJ, McClelland JM, Rutkowski SB, Cousins MJ. A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury. Pain. 2003;103:249–57. doi: 10.1016/S0304-3959(02)00452-9. - DOI - PubMed
    1. Siddall PJ, Middleton JW. A proposed algorithm for the management of pain following spinal cord injury. Spinal Cord. 2006;44:67–77. doi: 10.1038/sj.sc.3101824. - DOI - PubMed

LinkOut - more resources