Pain Characterization in Individuals with Spinal Cord Injury: Rehabilitation Implications and Associated Factors

Abstract

Introduction: Pain is a major complication among individuals with spinal cord injury (SCI), contributing to participation restrictions, reduced quality of life, and impaired function and independence. Characterizing pain in this population is essential to improve understanding of its clinical features and to inform healthcare strategies aimed at minimizing its impact on health and functioning.

Objective: To describe the clinical characteristics of pain and examine the clinical, functional, and sociodemographic factors associated with its presence in individuals with SCI.

Methods: This observational, cross-sectional, analytical study involved a review of medical records from patients with SCI treated at the National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra” between 2015 and 2023. A non-probability convenience sampling approach was used. Sociodemographic, clinical, and functional variables, as well as pain-related characteristics including pain type and intensity, were collected. Descriptive analyses, tests of association, and multivariable logistic regression were performed to identify factors associated with the presence of pain. Statistical significance was defined as p < 0.05.

Results: A total of 1,519 medical records were analyzed. The prevalence of pain was 16.7%, with neuropathic pain being the most common subtype (10.3%). Individuals with pain demonstrated lower functional independence than those without pain (SCIM III: 73.65 vs. 75.44; p = 0.027). In the multivariable logistic regression model, age was associated with a 1.3% increase in the odds of pain for each additional year of age (OR = 1.013; p = 0.050). Patients with cervical SCI had 2.33 times higher odds of pain compared with those with injuries below T1 (OR = 2.331; p = 0.003). Additionally, lower socioeconomic status was independently associated with greater odds of pain (OR = 0.736; p = 0.001).

Conclusions: Pain in individuals with SCI was predominantly neuropathic and was associated with lower functional independence. Older age, cervical neurological level of injury, and lower socioeconomic status were independently associated with the presence of pain. Recognition of these factors may facilitate the early identification of individuals at greater risk and support the development of targeted rehabilitation strategies aimed at reducing the functional burden of pain.