Participant perspectives on a multimodal program for neuropathic pain after spinal cord injury

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Abstract
Introduction: Spinal cord injury (SCI) results in several medical consequences. While some of these are immediate, others, like chronic pain, may emerge after weeks or months. Roughly 60% of individuals develop persistent neuropathic pain within the first year after injury. Due to the limited efficacy and negative side-effects of current pharmacological agents, many patients seek non-pharmacological options. Methods: The present mixed-method study explored individual perspectives of 35 participants with neuropathic pain and SCI on a multimodal 12-week pain program including pain education, exercise, and walking illusions. Results: After completion of the program participants reported reduced pain and pain interference, better understanding of pain and pain management, and lower medication use. Other reported benefits included an expanded mindset, useful community and interpersonal connections, positive health impact, increased motivation, and elevated self-image. Negative perceptions included fatigue, short-lasting or minimal effects on pain, and lack of realism of walking illusions. Pain assessment scores supported the overall positive effects on neuropathic pain with significant reductions in neuropathic pain severity, pain interference with activities and mood, and difficulty dealing with pain. These results suggest that a multimodal pain program combining pain education, exercise and walking illusions can reduce neuropathic pain and its impact after SCI.

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