Pain prevalence and its determinants after spinal cord injury: A systematic review

Pain prevalence studies are important as they illustrate the magnitude of pain problems in a certain patient population, such as patients living with a spinal cord injury (SCI). Strikingly, reported pain prevalence rates in SCI patients are found to vary greatly, while determinants for the differences between pain prevalence reports remain unclear. We here aim to identify determinants for the differences (heterogeneity) in pain prevalence reports through a systematic review of all SCI pain prevalence reporting studies. Literature search was done using Medline, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge and Embase. Data abstraction was performed while blinded and was followed by meta‐(regression)‐analyses. We identified 82 studies. Study design‐related determinants of SCI pain prevalence reports were pain definition strictness (mild, moderate or high), primary study goal (pain study or not), data source (retrospective or not), and in a limited number of cases response/attrition rates. While correcting for these items, population characteristics correlating with pain prevalence rates were both proportion of patients with a depression and average time after injury (positive correlations). Between‐study heterogeneity may remain even after the identification/correction of above‐mentioned causes of heterogeneity.Pain after SCI does seem to relate to the duration of the injury and depression, yet major causes of bias in reported pain prevalence are found to be related to the primary study goal (pain study or not), choice of pain definition and the use of retrospective data.

[1]  N. Hasnan,et al.  Characteristics of persons with spinal cord injury who drive in Malaysia and its barriers: a cross sectional study , 2017, Spinal Cord.

[2]  Asiah Ibrahim,et al.  Epidemiology of Spinal Cord Injury in Hospital Kuala Lumpur , 2013, Spine.

[3]  M. D. de Wit,et al.  Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions , 2012, Annals of the rheumatic diseases.

[4]  A. Curt,et al.  Low depressive symptoms in acute spinal cord injury compared to other neurological disorders , 2012, Journal of Neurology.

[5]  N. Finnerup,et al.  Spinal Cord Injury Pain: Mechanisms and Management , 2012, Current Pain and Headache Reports.

[6]  G. Zeilig,et al.  The nature and course of sensory changes following spinal cord injury: predictive properties and implications on the mechanism of central pain. , 2012, Brain : a journal of neurology.

[7]  James S. Krause,et al.  A longitudinal study of depression in survivors of spinal cord injury , 2011, Spinal Cord.

[8]  J. Hoffman,et al.  A longitudinal study of depression from 1 to 5 years after spinal cord injury. , 2011, Archives of physical medicine and rehabilitation.

[9]  R. Brown,et al.  Depressive symptoms and bodily pain: The role of physical disability and social stress. , 2011, Stress and health : journal of the International Society for the Investigation of Stress.

[10]  C. Schmidt,et al.  Does attrition bias longitudinal population‐based studies on back pain? , 2011, European journal of pain.

[11]  J. Nyengaard,et al.  Spinal-, brainstem- and cerebrally mediated responses at- and below-level of a spinal cord contusion in rats: Evaluation of pain-like behavior , 2010, PAIN®.

[12]  D. Gupta,et al.  Spinal cord injuries containing asymmetrical damage in the ventrolateral funiculus is associated with a higher incidence of at-level allodynia. , 2010, The journal of pain : official journal of the American Pain Society.

[13]  J. Higgins,et al.  Cochrane Handbook for Systematic Reviews of Interventions , 2010, International Coaching Psychology Review.

[14]  D. Wolfe,et al.  A systematic review of pharmacologic treatments of pain after spinal cord injury. , 2010, Archives of physical medicine and rehabilitation.

[15]  Y. Cruz-Almeida,et al.  Pain symptom profiles in persons with spinal cord injury. , 2009, Pain medicine.

[16]  B. C. Hains,et al.  Remote neuroimmune signaling: a long-range mechanism of nociceptive network plasticity , 2009, Trends in Neurosciences.

[17]  Hasse Karlsson.  The prevalence of what? , 2009, Nordic journal of psychiatry.

[18]  J. Ioannidis,et al.  Systematic Review of the Empirical Evidence of Study Publication Bias and Outcome Reporting Bias , 2008, PloS one.

[19]  M. Jann,et al.  Antidepressant Agents for the Treatment of Chronic Pain and Depression , 2007, Pharmacotherapy.

[20]  A. Mokhtari,et al.  Reports from Spinal Cord Injury Patients: Eight Months after the 2003 Earthquake in Bam, Iran , 2007, American journal of physical medicine & rehabilitation.

[21]  I. L. Johannesen,et al.  Segmental hypersensitivity and spinothalamic function in spinal cord injury pain , 2007, Experimental Neurology.

[22]  K. Raichle,et al.  Cognitions, coping, and social environment predict adjustment to pain in spinal cord injury. , 2007, The journal of pain : official journal of the American Pain Society.

[23]  C. Molander,et al.  The prevalence of neuropathic pain after non-traumatic spinal cord lesion , 2007, Spinal Cord.

[24]  S. Waxman,et al.  Modulation of Thalamic Nociceptive Processing after Spinal Cord Injury through Remote Activation of Thalamic Microglia by Cysteine–Cysteine Chemokine Ligand 21 , 2007, The Journal of Neuroscience.

[25]  D. Amtmann,et al.  Symptom burden in persons with spinal cord injury. , 2007, Archives of physical medicine and rehabilitation.

[26]  Henk J Stam,et al.  Complications following spinal cord injury: occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation. , 2007, Journal of rehabilitation medicine.

[27]  Tania B. Huedo-Medina,et al.  Assessing heterogeneity in meta-analysis: Q statistic or I2 index? , 2006, Psychological methods.

[28]  P. Henningsen,et al.  Depression, pain, and somatoform disorders , 2006, Current opinion in psychiatry.

[29]  Y. Cruz-Almeida,et al.  Chronicity of pain associated with spinal cord injury: A longitudinal analysis. , 2005, Journal of rehabilitation research and development.

[30]  P. Mäntyselkä,et al.  Frequent analgesic use at population level: Prevalence and patterns of use , 2005, Pain.

[31]  M. Jensen,et al.  Chronic pain in individuals with spinal cord injury: a survey and longitudinal study , 2005, Spinal Cord.

[32]  C. Molander,et al.  Neuropathic pain after traumatic spinal cord injury – relations to gender, spinal level, completeness, and age at the time of injury , 2004, Spinal Cord.

[33]  C. Gyldensted,et al.  MRI in chronic spinal cord injury patients with and without central pain , 2003, Neurology.

[34]  W. Katon,et al.  Depression and pain comorbidity: a literature review. , 2003, Archives of internal medicine.

[35]  S. Rutkowski,et al.  A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury , 2003, Pain.

[36]  N. Finnerup,et al.  Sensory function above lesion level in spinal cord injury patients with and without pain , 2003, Somatosensory & motor research.

[37]  Roland Peyron,et al.  Laser-evoked potential abnormalities in central pain patients: the influence of spontaneous and provoked pain. , 2002, Brain : a journal of neurology.

[38]  P. Joseph,et al.  The Tetrafigap Survey on the long-term outcome of tetraplegic spinal cord injured persons: Part III. Medical complications and associated factors , 2002, Spinal Cord.

[39]  P. New,et al.  Nontraumatic spinal cord injury: demographic characteristics and complications. , 2002, Archives of physical medicine and rehabilitation.

[40]  W. Mckinley,et al.  Comparison Of Medical Complications Following Nontraumatic And Traumatic Spinal Cord Injury , 2002, The journal of spinal cord medicine.

[41]  H. Boshuizen,et al.  Selection bias due to non-response in a health survey among patients with rheumatoid arthritis. , 2002, European journal of public health.

[42]  Kay Dickersin,et al.  Systematic reviews in epidemiology: why are we so far behind? , 2002, International journal of epidemiology.

[43]  B H Chang,et al.  Meta‐analysis of binary data: which within study variance estimate to use? , 2001, Statistics in medicine.

[44]  T. Jensen,et al.  Pain and dysesthesia in patients with spinal cord injury: A postal survey , 2001, Spinal Cord.

[45]  J. Ravaud,et al.  Subjective well-being and severe motor impairments: the Tetrafigap survey on the long-term outcome of tetraplegic spinal cord injured persons. , 2001, Social science & medicine.

[46]  B. Walker,et al.  The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. , 2000, Journal of spinal disorders.

[47]  R. Chintam,et al.  Characteristics Of Persons With Spinal Cord Injury As Documented By Use Of An Interactive Data System , 2000, The journal of spinal cord medicine.

[48]  Blair H. Smith,et al.  The epidemiology of chronic pain in the community , 1999, The Lancet.

[49]  M. Egger,et al.  The hazards of scoring the quality of clinical trials for meta-analysis. , 1999, JAMA.

[50]  S. Rutkowski,et al.  Pain report and the relationship of pain to physical factors in the first 6 months following spinal cord injury , 1999, Pain.

[51]  D. Cook,et al.  Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? , 1998, The Lancet.

[52]  C. Leboeuf‐Yde,et al.  The Prevalence of Low Back Pain in the Literature A Structured Review of 26 Nordic Studies From 1954 to 1993 , 1995, Spine.

[53]  R. J. Hayes,et al.  Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. , 1995, JAMA.

[54]  S G Thompson,et al.  Systematic Review: Why sources of heterogeneity in meta-analysis should be investigated , 1994, BMJ.

[55]  S Greenland,et al.  Invited commentary: a critical look at some popular meta-analytic methods. , 1994, American journal of epidemiology.

[56]  C. Friedenreich,et al.  INFLUENCE OF METHODOLOGIC FACTORS IN A POOLED ANALYSIS OF 13 CASE‐CONTROL STUDIES OF COLORECTAL CANCER AND DIETARY FIBER , 1994, Epidemiology.

[57]  A. Mariano,et al.  Chronic pain and spinal cord injury. , 1992, The Clinical journal of pain.

[58]  D M Eddy,et al.  Synthesis of environmental evidence: nitrogen dioxide epidemiology studies. , 1992, Journal of the Air & Waste Management Association.

[59]  G. Whiteneck,et al.  Health and psychosocial issues of individuals with incomplete and resolving spinal cord injuries , 1992, Paraplegia.

[60]  J D Emerson,et al.  An empirical study of the possible relation of treatment differences to quality scores in controlled randomized clinical trials. , 1990, Controlled clinical trials.

[61]  Gunilla Brattberg,et al.  The prevalence of pain in a general population. The results of a postal survey in a county of Sweden , 1989, Pain.

[62]  D. Locker,et al.  Response trends and nonresponse bias in a mail survey of oral and facial pain. , 1988, Journal of public health dentistry.

[63]  Marcel Dijkers,et al.  Prevalence of chronic pain after traumatic spinal cord injury: a systematic review. , 2009, Journal of rehabilitation research and development.

[64]  P. Siddall,et al.  Biopsychosocial perspective on a mechanisms-based approach to assessment and treatment of pain following spinal cord injury. , 2009, Journal of rehabilitation research and development.

[65]  R. Chintam,et al.  A database of self-reported secondary medical problems among VA spinal cord injury patients: its role in clinical care and management. , 2002, Journal of rehabilitation research and development.

[66]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. , 2000, JAMA.

[67]  G. Whiteneck,et al.  Secondary conditions following spinal cord injury in a population-based sample , 1998, Spinal Cord.

[68]  A. M. Purves,et al.  Defining chronic pain for epidemiological research: assessing a subjective definition , 1998 .