Investigating the biopsychosocial factors involved in chronic pain in people with a spinal cord injury

Abstract

It is estimated that over 62% of people with a spinal cord injury (SCI) experience chronic pain, (Ullrich, Jensen, Loesser & Cardenas, 2007), and yet in the UK there is currently no tailored pain management programme. SCI pain is unusually resistant to standard pain management programmes (Perry, Nicholas & Middleton, 2010). The development of a tailored programme requires a profile of the biological, psychological, and social characteristics of chronic pain sufferers with SCI but the existing knowledge base is fragmented. This study is examining the range and interactions of the characteristics that could be involved. This will inform the development of appropriate and specific treatment programmes. A longitudinal, multiple assessment-point design will be used with 60 spinal cord injured in-patients at the National Spinal Injuries Centre (NSIC), Stoke Mandeville. Participants will be asked to complete a set of two pain assessment questionnaires and six psychological assessments at three, six and twelve months after admission to the NSIC and to provide salivary cortisol samples on each occasion to assess the biological marker of stress. Additionally, a cross-sectional study using the same questionnaires and cortisol sampling will be undertaken with 60 out-patients of the NSIC who have been out of hospital for a minimum of two years. Data has been collected from 80 participants and time-two data collection has begun with the in-patients. It is anticipated that the outcome of the research will be the generation of a knowledge base from which a SCI-specific pain management programme will be designed and piloted.