Evaluation of an interdisciplinary program for chronic pain after spinal cord injury
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OBJECTIVE: To assess efficacy of an interdisciplinary pain program adapted for persons with spinal cord injury (SCI) and chronic pain. DESIGN: Prospective cohort. SETTING: University-affiliated rehabilitation hospital. PARTICIPANTS: Twenty-two persons with traumatic or nontraumatic SCI and chronic pain of at least 6 months’ duration. METHODS: Subjects participated in an interdisciplinary pain program consisting of biweekly group sessions for 10 consecutive weeks. Sessions incorporated patient education on chronic pain and associated pain mechanisms, cognitive behavioral therapy, self-management strategies (eg, energy conservation, ergonomics, goal setting, stress management, anger management, and coping skills), group discussions and activities, and either exercise or guided relaxation at the end of each session. MAIN OUTCOME MEASURES: Multidimensional Pain Inventory SCI, Coping Inventory of Stressful Situations, Pain Stages of Change Questionnaire, and Life Satisfaction Questionnaire. RESULTS: After participation in an interdisciplinary pain program, persons with SCI and chronic neuropathic pain demonstrated increased involvement in learning and maintenance of coping strategies for chronic pain. Participation also led to less pain interference in daily life and a greater sense of control over one’s life. CONCLUSIONS: Participation in an interdisciplinary pain program does not reduce pain severity, but it can help persons with SCI and chronic neuropathic pain cope with pain, lessen interference of pain, and improve their sense of control.