Effects of chronic pain on function, depression, and sleep among patients with traumatic spinal cord injury

BACKGROUND AND OBJECTIVES: The main objectives of this cross-sectional study were (1) to examine chronic pain using the Multidimensional Pain Inventory-Spinal Cord Injury (MPI-SCI) version and (2) to assess the relationship between chronic pain and functional status, depression, and sleep quality among patients with SCI. DESIGN AND SETTINGS: This was a cross-sectional study of all eligible patients admitted to the Ministry of Health Ankara Diskapi Yildirim Beyazit Education and Research Hospital Physical Therapy and Rehabilitation Clinic between January 2007 and July 2010. METHODS: Forty-four patients (33 male, 11 female) with traumatic SCI, aged ≥18 years, who had pain continuing for ≥6 months and were hospitalized in the physical therapy and rehabilitation clinic were included in this cross-sectional study. Chronic pain intensity, functional status, depression, and sleep quality were assessed according to the MPI-SCI, Functional Independence Measure (FIM), Hamilton Rating Scale for Depression (HAM-D), and Pittsburg Sleep Quality Index (PSQI), respectively. RESULTS: A positive correlation was observed between “Pain Severity” (one of the subscales of the MPI-SCI) and HAM-D (r=0.487, P=.001) and PSQI (r=0.312, P=.039). “Pain Severity” was significantly higher in the “impaired sleep” group (P<.05) than in the “normal sleep” group and in the “depression” group (P<.05) than in the “no depression” group. CONCLUSION: We identified a strong interrelationship between SCI-related “Pain Severity” and both depression and sleep quality. Hence, a comprehensive pain examination and management strategies including psychosocial interventions should be given particular consideration to address the critical issue of chronic pain in individuals with SCI.