Article Figures & Data
Figures
- Figure 1
Pain diagrams demonstrating the distribution and severity of neuropathic pain for each individual.
Tables
- Table 1
The anatomical distribution of pain throughout the body assessed in the initial consultation.
Pain throughout the body n Head 0 Face 0 Mouth and throat 0 Shoulder 10 Arms 9 Elbows 6 Forearms 7 Wrists 6 Hands 9 Chest 5 Abdomen 11 Multiple joints 7 Groin 10 High back 10 Middle back 10 Low back 11 Buttock 18 Thighs 15 Knees 14 Legs 15 Ankles 12 Urogenital area 5 Bones 6 Different muscles 5 Pain quality descriptors n Burning 30 Pins & needles 26 Electric shock 22 numbness 18 Shooting 16 Stabbing 16 Pressure 10 Spontaneous pain 16 Throbbing (pulsate) 13 Allodynia 9 Sharp pain 8 Dysesthesia 6 Evoked pain 5 Hyperalgesia 5 Hyperesthesia 5 Hypoesthesia 5 Itching 5 Aching 2 - Table 3
Frequency of exacerbating and alleviating factors for pain assessed in the initial consultation.
Intensifying factors n Relieving factors n Cold 20 Warmth 18 Activity 18 Resting 16 Emotional stress 17 Massage 15 Coughing/sneezing 9 Mental relaxation 10 Bending forward 9 Activity 3 Bending backward 5 Travelling 4 Bending 8 Bending forward 3 Rotation the body 5 Cold 1 Sleeplessness 8 Bending backward 0 Warmth 4 Bending to the parties 0 Walking* 2 Rotation to the parties 0 Resting 2 Walking* 0 Oversleeping 1 Urination** 2 Defecation** 2 Sexual intercourse** 4 - Table 4
Non-pharmacological treatments used by individuals with chronic SCI prior to their initial visit.
Non-pharmacological treatments n Massage therapy 10 Exercising 7 Nerve block injections 5 TENS* 5 Acupuncture 4 Traction 4 Movement therapy 3 Thermotherapy 2 Psychotherapy 2 Hypnotism 0 Ultrasound 0 Biofeedback 0 Others 6 ↵* Transcutaneous electric nerve stimulation
- Table 5
Treatments administered for the individuals with chronic SCI by the pain clinic evaluated after 6-month of treatment.
Treatments n Amitriptyline 25 Gabapentin 24 Capsaicin+ Lidocaine 23 Lidocaine perfusion 17 Ketorolac 16 Baclofen 16 Venlafaxine 11 Ketamine perfusion 8 Pregabalin 8 Nitroglycerin ointment 8 Acetaminophen 6 TENS* 5 Duloxetine 4 Diclofenac sodium 4 Nortriptyline 3 All the other pharmacological treatments 20 ↵* Transcutaneous electric nerve stimulation
- Table 6
Mean difference of ‘maximal pain intensity’, ‘overall pain intensity during the past week’ and ‘the pain intensity at the time of the initial consultation’ in pain clinic and after 6 months of treatment (measured by NRS) in the individuals with chronic SCI.
Variables Initial consultation After 6-month of follow-up Mean difference P-value Maximal pain intensity 8.71±1.73 7.65±1.73 -1.06 0.01 Overall pain intensity during the past week 6.32±1.60 5.30±1.79 -1.02 0.01 The pain intensity at the time of the consultation 6.11±2.48 4.59±2.46 -1.52 0.01 - Appendix 1
Characteristics of individuals with spinal cord injury referring to our clinic based on International Spinal Cord Injury Pain (ISCIP) Classification.
No. Age Gender Cause of SCI Level of SCI Time duration from SCI Spine fixation surgery ISCIP classification Tier 1 ISCIP classification Tier 2 ISCIP classification Tier 3 Pain diagram 1 45 Male Fall Thoracic (T4) 6 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-A 2 19 Female MVC Lumbar (L1) 3 yrs + Neuropathic pain At level SCI neuropathic pain Cauda equina compression Figure1-B 3 54 Male Fall Thoracic (T12) 5 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain At level SCI neuropathic pain Muscular pain Spinal cord compression Figure1-C 4 32 Male MVC Thoracic (T6-T7) 2 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-D 5 44 Male MVC Cervical (C5-C6) 3 yrs Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-E 6 51 Female MVC Cervical (C6) 1.5 yrs + Neuropathic pain At level SCI neuropathic pain Nerve root compression Figure1-F 7 31 Male MVC Thoracic (T4-T5) 1 yr + Neuropathic pain At level SCI neuropathic pain Spinal cord compression Figure1-G 8 45 Male Trauma (Heavy object falling on back) Thoracic (T12) 3.5 yrs + Neuropathic pain At level SCI neuropathic pain Cauda equina compression Figure1-H 9 45 Female MVC Thoracic (T8) 2 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Glenohumeral arthritis, lateral epicondylitis Spinal cord compression Figure1-I 10 36 Female MVC Thoracic (T5-T6) 14 mo Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain associated with autonomic features (sweating) Muscular pain Spinal cord compression Figure1-J 11 46 Male MVC Cervical (C6-C7) 2 yrs + Neuropathic pain At level SCI neuropathic pain Spinal cord compression Figure1-K 12 37 Female MVC Lumbar (L1-L2) 14 yrs + Neuropathic pain At level SCI neuropathic pain Spinal cord compression Figure1-L 13 64 Male MVC Cervical (C5-C6) 42 yrs Neuropathic pain At level SCI neuropathic pain Spinal cord compression Figure1-M 14 64 Male Fall Lumbar (L1-L2) 2.5 yrs + Neuropathic pain At level SCI neuropathic pain Cauda equina compression Figure1-N 15 52 Male MVC Thoracic (T12) 3 yrs + Nociceptive pain Neuropathic pain Other nociceptive pain Musculoskeletal pain At level SCI neuropathic pain Surgical skin incision Muscular pain and spasm Cauda equina compression Figure1-O 16 31 Male MVC Cervical (C5-C6-C7) 4 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Muscular pain and spasm lumbar facet syndrome Spinal cord compression Figure1-P 17 76 Male Spine dissection due to sudden bending Lumbar (L4-L5) 8 yrs Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-Q 18 27 Male MVC Thoracic (T11-T12) 1 yr + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-R 19 28 Male MVC Thoracic (T10-T11) 10 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain At level SCI neuropathic pain (cauda equina syndrome) Muscular pain Cauda equina compression Figure1-S 20 48 Female MVC Cervical (C5-C6) 1 yr + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-T 21 50 Male MVC Thoracic (T11) 4 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Lumbar facet syndrome Muscular pain and spasm Spinal cord compression Figure1-U 22 33 Female MVC Cervical (C3-C4) 2 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Lumbar facet syndrome Glenohumeral arthritis Spinal cord compression Figure1-V 23 53 Male MVC Lumbar (L1) 2 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain At level SCI neuropathic pain Ankle joint arthritis Spinal cord compression Figure1-W 24 54 Male Fall Cervical (C4-C5) 8 mo + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Muscular pain Spinal cord compression Figure1-X 25 51 Male Trauma (Heavy object falling on back) Thoracic (T12) 10 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain At level SCI neuropathic pain Muscular pain and spasm Spinal cord compression Figure1-Y 26 31 Male Fall Cervical (C6) 4 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-Z 27 34 Male Trauma (gymnastic) Cervical (C5-C6) 10 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-a 28 39 Male Fall Thoracic (T10-T11) 3 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Quadrates lumborum muscle spasm Spinal cord compression Figure1-b 29 37 Male T8 surgery screw malposition Thoracic (T8) 15 mo + Neuropathic pain At level SCI neuropathic pain Nerve root compression Figure1-c 30 29 Male MVC Thoracic (T5-T6) 3 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Muscular pain Spinal cord compression Figure1-d 31 31 Male MVC Lumbar (L1) 12 yrs + Neuropathic pain At level SCI neuropathic pain Cauda equina compression Figure1-e 32 60 Male Trauma (slipping) Thoracic (T12) and L1 7 yrs + Neuropathic pain At level SCI neuropathic pain Cauda equina compression Figure1-f 33 57 Male MVC Cervical (C6-C7) 15 mo + Nociceptive pain Neuropathic pain Visceral pain At level SCI neuropathic pain Bowel impaction Spinal cord compression Figure1-g 34 59 Male MVC Thoracic (T12) 30 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-h 35 42 Female MVC Cervical (C5-C6) 6 yrs + Neuropathic pain At level SCI neuropathic pain Spinal cord compression Figure1-i 36 58 Male MVC Cervical (C4) 3 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-j 37 18 Female Complicated LP Lumbar (L2) 5 yrs Nociceptive pain Neuropathic pain Musculoskeletal pain At level SCI neuropathic pain (cauda equina syndrome) Muscular spasm and pain Cauda equina injury Figure1-k 38 44 Male Fall Thoracic (T10-T11) 2.5 yrs + Neuropathic pain Below level SCI neuropathic pain Spinal cord compression Figure1-l 39 57 Male Angiography of thoracic arteries Thoracic (T7-T8) 3 mo Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Muscular pain Spinal cord ischemia Figure1-m 40 35 Female MVC Thoracic (T6) 3 yrs + Nociceptive pain Neuropathic pain Musculoskeletal pain Below level SCI neuropathic pain Thoracic facet syndrome Spinal cord compression Figure1-n MVC - Motor Vehicle Crash, SCI - Spinal Cord Injury, ISCIP - International Spinal Cord Injury Pain, + - Spine fixation surgery was carried out
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