The Effect of the SCI Pain Clinic on Pain in Spinal Cord Injury

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The Effect of the SCI Pain Clinic on Pain in
Spinal Cord Injury Heidi K.Wennemer, D.O., M.A.,
Hammam Akbik, M.D., David Binder M.D., and Beth
Tammaro BSN, RN, CRRN
Abstract Pain is a common problem with spinal
cord injury and a significant number of these
patients suffer from severe chronic pain.
Treatment of chronic pain is often difficult and
pain clinics are usually referred patients who
fail to respond to traditional therapies. We
administered anonymous questionnaires to all SCI
patients who visited the pain clinic over a 9
month period. 70 of patients reported
improvement in their pain after treatment in
this multidisciplinary pain clinic. The average
pain score, using the numeric scale of 1-10,
decreased from 7.79 (severe) to 5.74 (moderate).
70 of patients felt improvement. The SCI Pain
Clinic successfully utilizes a multidisciplinary
team approach to minimize pain and maximize
function in SCI patients with chronic pain.
Introduction 69 of SCI patients have pain, and
one third of those (23) have severe pain. Pain
is divided into three types acute pain lasts 1
day to 3 months, subacute lasts 3-6 months, and
chronic pain is defined as pain lasting for over
6 months. Patients with severe chronic pain are
difficult to treat, and treatments that work on
acute and subacute pain often fail when treating
chronic pain. To help combat this problem, the
SCI Pain Clinic was established in 2002.  The SCI
Service and Anesthesia Department established a
one of a kind specialty clinic to address the
unique pain management needs of the SCI
population. Under the direction of Dr. Hammam
Akbik, a pain specialist, the SCI/Anesthesia Pain
Clinic utilizes a multidisciplinary team of
spinal cord physicians, the rehabilitation team,
nursing, psychology, and pharmacy to minimize
pain while maximizing function.   This clinic
offers multiple pain management modalities
including medical therapy, interventional
procedures, as well as implantable devices such
as spinal cord stimulators, intrathecal pumps,
and other therapies.

• Methods
• Anonymous questionnaires were given to all SCI
  patients who visited the pain clinic over a 9
  month period.
• 55 patients completed both initial and follow up
  questionnaires and were included in the study.
• Statistical analysis of the before and after
  treatment data consisted of paired t-test.
• Intention to treat analysis was also carried out
  using all 58 patients who responded to either
  questionnaire.
• Results
• 70 of SCI patients with chronic pain felt
  better after treatment in the pain clinic
• There was a significant reduction in pain after
  treatment plt0.0001, (n55).
• Intention to treat analysis (n58) was also
  significant plt0.0001.
• The average pain score decreased from 7.79 (Very
  Severe) to 5.74 (Moderate-Severe), a difference
  of over 2 points.
• Pain Scale

Plt 0.0001