Spinal Cord Injury Can Result In Significant Psychological And Social Problems
Research from the Christchurch School of Medicine and Health Sciences, Otago University, has confirmed for the first time that a high proportion of New Zealanders with severe spinal cord injury and subsequent chronic pain experience ongoing psychological and social problems because of their condition.
Dr Mark Turner from the Department of Orthopaedic Surgery and Musculoskeletal Medicine says the wider community, and to a lesser extent health professionals, still do not understand the extent or effect that chronic pain has on patients who have traumatic spinal cord injury.
His doctoral research shows more attention needs to be paid to the psychological impacts of this kind of serious injury, and to assist the Rehabilitation of those confined to wheelchairs for the rest of their lives.
“Chronic pain generally is a serious but relatively hidden problem in New Zealand,” explains Dr Turner. “ For those with the devastating long-term consequences of spinal cord injuries, the focus is still very much on clinical issues. But pain can have a serious impact on psychosocial functioning, beyond the impact of the injury. In fact, in the present study one-third of people considered pain to be their primary problem when considering all aspects of their injury.”
Dr Turner researched the lives of 122 individuals with serious spinal cord injury who were living in Christchurch at the time of injury. Over three quarters (77%) reported they still experienced some chronic pain, and that relatively high levels of pain significantly affected their quality of life in the community.
Those with high levels of ongoing, chronic pain reported experiencing greater psychological distress (58%), suicidal thoughts (39%), major Depression (32%), anxiety (26%), and overall psychiatric problems (48%) compared to those without pain.
Many also said they had a poor social life including a smaller social network (65%), low social participation (64%), and low social integration (39%). Higher pain intensity is also associated with poor adjustment to Disability and lower life satisfaction generally.
Dr Turner says that overall his research shows that mainly young men have been provided with excellent clinical treatment, but are still struggling with the consequences of chronic pain after serious spinal cord injury, and often not coping with their disability. The upbeat image of the disabled often portrayed in the media and elsewhere, in such events as the Paralympics, is not always the full story he says.
“Many people with serious spinal cord injuries do make a good recovery, but there are a significant number with chronic pain who need more help and recognition when they leave hospital. There is a tendency for the good news from the achievers, to distract from the needs of those who have the kind of continuous problems revealed in my research.”
Dr Turner says the needs of those suffering from serious spinal injury must have more holistic recognition by health professionals and society. Even in a condition as physically disabling as spinal cord injury, the impact of unseen factors such as chronic pain may be every bit as distressing as the more obvious issues such as paralysis. While issues associated with chronic pain may previously have been overlooked in the aftermath of spinal cord injuries, this research shows that for many people it is the pain and not paralysis that is the major obstacle to rehabilitation.
