Disclosures: Javier A. Santana, MD: Nothing to disclose

Objective: Describe changes in pain, and associations between pain severity and depressive symptoms, 1 year after traumatic spinal cord injury (SCI).

Design: As part of a larger randomized clinical trial for the prevention/reduction of neuropathic pain using transcutaneous electrical nerve stimulation (TENS), longitudinal data were collected regarding pain and psychological status during the first year after SCI.

Setting: University-affiliated hospital.

Participants: Traumatic SCI patients within 4 months of injury.

Interventions: Either 16 sessions of TENS therapy or sham-TENS. For this preliminary analysis in our first 10 participants, comparisons between intervention groups are not appropriate, thus the analyses are based on combined data.

Main Outcome Measures: Numerical rating scale (NRS) for average overall pain intensity and unpleasantness during the past week. Spinal Cord Injury Pain Instrument (SCIPI) screens for neuropathic pain after SCI. Neuropathic Pain Symptom Inventory (NPSI) for neuropathic pain-specific symptom severity. Patient Health Questionnaire 9 (PHQ-9) assesses the severity of depressive symptoms.

Results: At baseline assessment, 8 of the 10 participants had at least one neuropathic pain (SCIPI ≥2), and at the 12-month assessment, 5 participants had at least one neuropathic pain. Based on NPSI score, 3 participants had decreases in pain severity of at least 30% between baseline and 12-months post-injury; 3 had increases of at least 30%, and 2 had changes not exceeding 30%. While ratings of pain unpleasantness were significantly correlated with PHQ9 at baseline (rho = 0.82, P = .004), this relationship was not maintained at 12-months (rho = 0.19, P = .65).

Conclusions: Chronic pain after SCI greatly impacts quality of life and rehabilitation outcomes. The trajectories of pain reports during the first year following traumatic SCI are heterogeneous, as is the relationship between pain and depressive symptoms. Research regarding predictive factors for the development of chronic pain is needed in order to best implement targeted preventive and treatment strategies.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/prospective-assessment-of-pain-during-the-first-year-after-spinal-cord-injury/