Article

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. IMPLICATIONS FOR REHABILITATION: 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.

Langue : ANGLAIS