Living with chronic neuropathic pain after spinal cord injury: an interpretative phenomenological analysis of community experience
Abstract
PURPOSE: This article presents an in-depth, idiographic study examining the lived experience of chronic pain following spinal cord injury (SCI). Neuropathic pain (NP) occurs in a large majority of the SCI population and is particularly intractable to treatment. It can be both psychologically and physically debilitating. This study examines how the experience of NP is mediated by its meaning to the sufferer. METHODS: Semi-structured interviews were conducted with eight people with SCI and chronic NP, attending outpatient clinics at a specialist SCI Centre in the UK. Verbatim transcripts were subjected to interpretative phenomenological analysis to further understand the experience. RESULTS: Analysis suggested that NP has powerful consequences upon the sufferer's physical, psychological and social well-being, in line with a biopsychosocial understanding of pain. Three super-ordinate themes were identified: a perceived gap between treatments received and participants' views of what they wanted and needed; a fight for life control and acceptance; and feeling understood by others with SCI, but isolated from the non-understanding able-bodied. CONCLUSIONS: The results are discussed in terms of the possible application of acceptance-based therapy to NP and the potential for the alleviation of the debilitating consequences of NP. IMPLICATIONS FOR REHABILITATION: Chronic NP after SCI is often described as worse than the injury itself, often impacting upon the sufferers physical and psychological health. The experiences of persons with SCI-specific NP highlight the impact of pain on their physical, psychological and social health. This indicates that healthcare professionals should incorporate a biopsychosocial approach for managing pain post-SCI. Routine clinical follow-up of SCI patients with chronic NP, as well as comprehensive pain management treatment programmes, could address the three themes evidenced in the current study, by moving routine intervention with NP away from pain relief, towards pain management. Continued education for patients, friends, family members and healthcare professionals may be beneficial in promoting understanding and awareness of NP and its consequences following SCI.
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Qualitative evidence suggests that people with spinal cord injury want better access to psychological interventions.
“Indeed, qualitative evidence suggests that people with SCI want better access to psychological interventions [5]”
From Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: A systematic review (2020) · cites this paper as [5]
The discussion (p. 21) says participants wanted treatment that acknowledged their distress and life restrictions, and suggests acceptance-based therapies as a possible intervention. It does not establish that participants specifically wanted better access to psychological interventions; that is the authors’ proposed response, not a reported request. (LLM, conf=0.84)
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- Authors
- Hearn, J. H., Cotter, I., Fine, P., & A. Finlay, K.
- Affiliations
- University of Buckingham (GB)
- Stoke Mandeville Hospital (GB)
- Corresponding author
- Hearn, Jasmine H.
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2015-01-20
- Volume
- 37
- Issue
- 23
- Pages
- 2203-2211
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2018808490
- Cited by
- 59
- References
- 72
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 7 · 2016: 5
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Buckingham E-Archive of Research (University of Buckingham) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- chronic neuropathic pain, spinal cord injury, lived experience, biopsychosocial model of pain, acceptance-based therapy, pain management, treatment expectations, social isolation, psychological well-being, rehabilitation
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Female, Humans, Interviews as Topic, Neuralgia, Pain Measurement, Patient Discharge, Quality of Life, Spinal Cord Injuries, Patient Satisfaction, Qualitative Research, Chronic Pain, Pain Management
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