A survey of chronic pain in the pediatric spinal cord injury population

Background/Objective: Although several reports characterize pain associated with adult-onset spinal cord injury (SCI), little is known about the incidence and etiology of pain associated with pediatric-onset SCI. The purpose of this study was to assess the incidence and type of chronic pain in the pediatric SCI population and to evaluate the resulting impact on activities of daily living (ADLs). Methods: Patients attending clinic in a pediatric tertiary care facility in a major metropolitan area having sustained an SCI during childhood were asked to participate. Participants were assessed using the Adolescent Pediatric Pain Tool and the Lansky Play Performance Scale, 2 standardized assessments of pain and function, respectively. In addition, a questionnaire designed to characterize the population and the types of pain reported was administered. Results: Thirty-one participants were enrolled with an age range at the time of injury from 5 months to 18 years. Of this population, 65% reported chronic pain. The pain reports were classified as either nocioceptive (48%) or neuropathic (19%). Interference with ADLs and play was present in only 1 participant. Conclusion: Based on these pilot data, pain associated with a pediatric-onset SCI is common. The incidence of pain in this study approached the reported incidence of chronic pain in adult-onset SCI. In the present population, nocioceptive pain was more common than was neuropathic pain. These data suggest that although common, chronic pain associated with childhood SCI has a significantly smaller impact on daily activities than that. reported in the literature for adult-onset SCI.