Associations between neuropathic pain and clinical parameters, fuctional status, depression, anxiety and quality of life in spinal cord injury patients

Although the greatest loss is motional functional loss after Spinal Cord Injury (SCI), pain is one of the complications which occurs after the injury and effect several functions. Pain is one of the most difficult problems which has seen among the majority of the patients in different degrees after SCI. The purpose of our study is to detect the frequency of neuropatic and non-neuropathic pain among the SCI patients, to examine the relationship of the pain, functional status, the clinical and demographical properties in these patients and the effects of these parameters on quality of life, depression and anxiety. 84 patients have been evaluated who have treated at Dicle University Hospital Physical Therapy and Rehabilitatiton inpatient clinics and followed at rehabilitation Policlinics. Detailed general physical examination, neurologic examination and pain questionaire of the patients have been performed. In addition; depression, anxiety and quality of life questioned. Demographic properties, date of injuries, etiology, the period of the disease and the complications have been recorded. 2013 ASIA scale has been used for the neurologic level of the patients. Spasticity of the patients have been assessed by Modified Ashworth Scale, the functional ambulation levels of the patients have been assesed by Walking Index Spinal Cord Injury (WISCI), Functional Amulation Scale (FAS) and the functional independency levels of the patients have been assessed by Spinal Cord Independence Measure (SCIM) 3 scale. SF-36 has been used to evaluate the quality life of the patients while Beck Depression and Anxiety Scale have been used to evaluate the level and the intensity of the depression and anxiety. VAS and LANSS have been used for the level and the intensity of the neuropatic pain. While the 41,7 % (n=35) of the patients those were included in the study have neuropatic pain, in the 58,3 % (n=49) of the patients neuropatic pain haven't been detected. When the two groups who have neuropathic pain and who have no pain compared significant differences couldn't be found according to their age, sex and marital status between these two groups. Also there haven't been significant differences in educatioanl level when these two groups have compared. There have not detected any significant differences in terms of median disease period and etiologic factors (as traumatic, non-traumatic) between two groups (p>0.05). There haven't been any significant difference statistically in terms of neurologic level, status of completeness and the existence of complications when these two groups have been compared (p>0.05). When the VAS pain, VAS fatigue, VAS parasteshia, BECK depression, BECK anxiety score and the all parametres of the SF-36 scores have been compared between these two groups while VAS pain, VAS fatigue, VAS parasteshia scores are higher in the group which has neuropathic pain and these differences were statistically meaningful at level of significance (p≤0.005), there were no statistically significiant differences according to BECK depression and BECK anxiety score between two groups (p>0.05). SF-36 paramaters vitality, bodily pains, emotional status, total scores have been found lower in neuropathic pain group and this result was statistically meaningful (p≤0.005). When the Functional Ambulation Levels ( WISCI ) and SCIM 3 scores of the patients have been compared there haven't found any significant differences statistically between the two groups. In all patients there have been a positive correlation between the LANSS and VAS pain, fatigue, parasthesia socres and negative correlation between vitality, bodily pain, emotional status, social functions, mental health, total score of SF 36 paramaters (p≤0.005). There was no correlation between LANSS and age, gender, marital status, AIS scale, existence of complications and BEC depression score (p>0.005). Consequently, Neuropatic Pain is an important complication which has occured frequently after SCI and effects the quality of life and psychological status of the patients.