Chronic pain affects up to 80% of spinal cord injury survivors. Pain following SCI significantly impacts quality of life and is a major component of pain and suffering damages.

Types of Pain After Spinal Cord Injury

Neuropathic Pain

Neuropathic pain results from damage to the nervous system itself:

  • At-level neuropathic pain—occurs at the level of injury
  • Below-level neuropathic pain—felt in paralyzed areas despite no sensation
  • Characteristics—burning, tingling, shooting, electric-shock sensations
  • Often severe and disabling

Neuropathic pain affects 40-50% of SCI survivors and is notoriously difficult to treat.

Musculoskeletal Pain

Musculoskeletal pain develops from overuse and mechanical stress:

  • Shoulder pain—from wheelchair propulsion and transfers
  • Back and neck pain—from compensatory postures
  • Arm pain—from upper body overuse

Shoulder injuries affect 30-70% of long-term wheelchair users, often requiring surgery.

Visceral Pain

Pain from internal organs:

  • Bladder spasms
  • Bowel cramping
  • Often difficult to localize

Spasticity-Related Pain

Involuntary muscle contractions can cause:

  • Painful muscle spasms
  • Joint pain from sustained contractions
  • Sleep disruption

Pain Treatment and Costs

Medications

Common pain medications for SCI include:

  • Anticonvulsants—gabapentin, pregabalin for neuropathic pain
  • Antidepressants—duloxetine, amitriptyline for pain
  • Muscle relaxants—baclofen, tizanidine for spasticity
  • Opioids—controversial, limited effectiveness for neuropathic pain
  • Topical agents—lidocaine patches, capsaicin

Monthly medication costs: $200-$1,000+

Interventional Treatments

  • Nerve blocks
  • Spinal cord stimulators—$30,000-$60,000 with replacements
  • Intrathecal baclofen pumps—for severe spasticity
  • Botox injections—for spasticity and pain

Non-Pharmacological Treatment

  • Physical therapy
  • Acupuncture
  • Massage therapy
  • Psychological pain management
  • Transcutaneous electrical nerve stimulation (TENS)

Impact on Daily Life

Chronic pain affects every aspect of life:

  • Sleep disruption—difficulty falling and staying asleep
  • Activity limitation—pain restricts what you can do
  • Mood effects—depression and anxiety worsen with chronic pain
  • Concentration difficulties—pain interferes with cognitive function
  • Social isolation—pain limits participation in activities

Chronic Pain in Legal Cases

Economic Damages

Pain treatment costs include:

  • Lifetime medications—$100,000-$300,000+
  • Pain management visits—$5,000-$15,000/year
  • Interventional procedures—varies widely
  • Physical therapy for pain—ongoing costs

Non-Economic Damages

Chronic pain is a major component of pain and suffering damages:

  • Daily suffering quantified and presented to jury
  • Impact on quality of life documented
  • Lifelong duration emphasized

Proving Pain Damages

  • Medical records—documenting pain complaints and treatment
  • Pain diaries—your daily documentation of pain levels
  • Medication records—showing ongoing need for pain treatment
  • Expert testimony—pain medicine specialists explain chronic nature
  • Your testimony—describing daily pain experience

Challenges in Pain Cases

Invisible Symptoms

Pain isn't visible, making proof challenging:

  • Juries must understand pain exists in paralyzed areas
  • Neuropathic pain is counterintuitive (pain without sensation)
  • Defense may argue exaggeration

Documentation Is Critical

  • Consistent reporting in medical records
  • Pain rating scales documented
  • Treatment attempts showing genuine effort to address pain

Conclusion

Chronic pain is a devastating but invisible consequence of spinal cord injury. Both the economic costs of pain treatment and the non-economic suffering must be included in damage calculations. Thorough documentation of pain and its impact on your life is essential for recovering fair compensation.