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Pain in a Spinal Cord Injury - Topic Overview

Pain in a spinal cord injury (SCI) can be complicated and confusing. There are different types of pain, and they are often described in different ways. You may feel pain where you have feeling. But you may also feel pain in an area where otherwise you have no feeling. The pain may be severe at some times. But at other times it may disappear or bother you only a little.

The most common type of pain experienced with SCI is neuropathic pain around the injury area. This is also known as the "circle of fire" or the "ring of fire." Neuropathic pain is caused by damage to the nervous system. Other types of pain include musculoskeletal (pain in the bones, muscles, and joints), and visceral (pain in the abdomen).

Neuropathic pain

Neuropathic pain is caused by damage to the nervous system. It is common in SCIs.

  • Spinal cord injury (central) pain occurs in areas where you have lost some or all of your feeling. It is not related to movements you make or to your position. It is often described as tingling, numbness, or throbbing. This is sometimes called "the circle of fire."
  • Segmental pain often occurs around the "border" between where you have feeling and do not have feeling.
  • Nerve root entrapment pain occurs at or just below the level of injury. It results in brief instances of sharp pain or burning pain where your normal feeling stops. Even touching the area lightly may make the pain worse.

Musculoskeletal pain

Musculoskeletal pain occurs in the bones, joints, and muscles. Unlike neuropathic pain, movement affects it, and it is usually made worse by movement and eased with rest. It is often described as a dull or aching pain.

  • Secondary overuse pain is caused by the overuse of muscles in any part of the body. In people with an SCI, this often occurs because one muscle group is always used. For example, it may develop in the arm or shoulder as a result of pushing a manual wheelchair.
  • Muscle spasm pain is painful involuntary movements (spasms) of a body part that you cannot move or can only partially move. The pain is caused when muscles and joints are strained.
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