Category: Spinal Cord Injury; Pain Rehabilitation
To identify and describe the social factors in understanding and coping with chronic pain after spinal cord injury (SCI).
This qualitative study collected data using intensive semi-structured interviews and in-home participant-observation.
Data collection was at the University of Michigan's Department of Physical Medicine's research offices and in the local community across SE Michigan.
Participants (or Animals, Specimens, Cadavers) :
Participants (N=30) were sampled from a database of SCI patients espousing chronic pain and through volunteers on an online research recruitment portal. Participants had sustained spinal cord injuries and espoused an average pain of >4 out of 10. Of these 30, a subset (N=10) engaged in home visits.
Main Outcome Measure(s) :
Qualitative data were coded (NVivo 12) based on known and emergent domains. Coded responses were compiled into a matrix, which was analyzed for themes and associative patterns. Ethnographic field notes from home visits were analyzed to verify or refute findings from interview data.
Themes around chronic pain included frustration with clinicians and clinical pain control, social engagement as distraction from pain, planning for pain, and perseverance to meet social demands where pain would otherwise interfere. Quality of life discussions within the interviews were particularly telling, as pain was a highly salient factor. Home visits conformed to the themes of the interviews, but provided rich, firsthand observations.
The sociality of individuals experiencing chronic pain helped participants lessen pain burden and find ways to persevere. Comparing quality of life discussions with firsthand observations shed light on the importance of context and personal framing in defining life with chronic pain. Contextualizing and disseminating these experiences will help clinicians more readily recognize the salient social stories of chronic pain in their own SCI patients.
Haley Scott– Research Associate, Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan
Elizabeth Riedman– Research Associate, Department of Physical Medicine & Rehabilitation University of Michigan, Ann Arbor, Michigan
Denise Tate– Professor and Associate Chair for Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
Edward Rohn– Assistant Professor, Oakland University, Rochester, Michigan