Chronic pain is common after a spinal cord injury (SCI), with about two-thirds of all persons with SCI reporting persistent pain despite available treatments. Chronic pain after injury causes additional burdens over and above the other medical consequences of SCI itself and is therefore associated with lower general health and well-being and with higher levels of depression. Because the pain types that occur after this type of injury are often chronic and severe, there is a risk for a significant psychosocial impact and a substantially reduced quality of life. Although chronic pain after SCI has been the topic of multiple basic and clinical research studies, the insufficient management of pain continues to be a significant problem and an important unmet need after SCI. It is clear that in order to better manage pain after SCI, we need to increase our understanding of not only the underlying mechanisms of these pain conditions but also learn how people with SCI manage to live with their pain and what their expectations and experiences are regarding barriers and facilitators to successful pain management and optimal quality of life.

The proposed study focuses on several areas where important and critical knowledge gaps exist regarding the barriers and facilitators to optimal pain management, including medical treatments and self-remedies, role of healthcare providers and social attitudes, ability to cope with pain, role of social support, and on factors that may facilitate or hinder to return-to-work and participation in clinical trials. Previous research has shown that there is a critical need in the general SCI pain community to gain more information about pain and its treatments and importantly to understand how others with the same condition manage their pain.

The primary purpose of this proposal is to learn, based on the perspectives of those who live with these conditions, about the most important barriers and facilitators to coping and living with SCI and chronic pain. A long-term goal is to use the information collected within this study to develop a source of information available to military personnel, veterans, and the general SCI community, their families and healthcare providers.

Due to current and past international conflicts, there has been an increase in active military personnel and veterans who have sustained SCI. Most of these persons will develop chronic pain within the first year after injury, and this may become a lifelong condition. We expect that the results of this study will benefit people with SCI who experience chronic pain in multiple ways. In order to develop new and improved interdisciplinary treatment strategies including successful coping, we need to understand the factors that can facilitate better management of pain. This may include learning which types of treatments are perceived as helpful, which attitudes from healthcare professionals, families, and friends are perceived as helpful, which factors facilitate the ability to return to work and ability to access pain care and information. We also need to understand those factors that are perceived as important barriers so that we can reduce these and thus facilitate quality of life for those who live with SCI and chronic pain.