Pain correlates with social integration in individuals with traumatic spinal cord injury: A cross-sectional survey

Abstract

Objective: To describe the relationship between pain and social integration following spinal cord injury using comprehensive evaluation of pain-related clinical characteristics and different aspects of social integration. Design: A cross-sectional study. Participants: A total of 318 participants with American Spinal Cord Injury Association Impairment Scale (AIS) Grades A, B, C or D and > 3 months post-injury. Methods: All participants completed the survey relating to demographics, pain characteristics, and the Craig Handicap Assessment Reporting Technique Social Integration scores. Results: Individuals who were younger, those 3–6 years after injury, and those with a grade of AIS grade A (odds ratio (OR) 8.32, 95% confidence interval (95% CI) 1.83–12.07) or B (OR 3.25, 95% CI 0.91–7.63) were more likely to report neuropathic pain. Significant inverse correlations were found between pain intensity and social integration (R = –0.597, p = 0.019). Brief Pain Inventory interference scores were negatively associated with 5 (friends, living situation, business, strangers and family) of 6 domains of Craig Handicap Assessment Reporting Technique social integration (p < 0.001). Pain type and only 1 domain (strangers) showed a significant negative relationship (B=–1.47, p = 0.02). Conclusion: Chronic pain after spinal cord injury is negatively associated with Craig Handicap Assessment Reporting Technique social integration. Brief Pain Inventory Pain interference, to a greater extent than pain type, best predicts social integration after spinal cord injury.