altBeside the apparent consequences after SCI as loss of motor, sensory and autonomic functions, pain is often rated by patients as one of their major problems. The prevalence of pain in SCI patients is approximately 69%, and one-third rate their pain as severe. It was therefore consequential to incorporate a pain assessment into the EM-SCI: First to have a long term follow up on pain after SCI to improve prediction of chronification and second to have a database for novel therapeutically interventions.

A screening tool for pain after spinal cord injury was developed. The pain questionnaire, conceived as a structured interview, examined various aspects of pain as well as pain associated psychosocial factors. Most important, it must assess pain syndromes to finally classify pain types according to the International Association for the Study of Pain (IASP, 2001). Based on this taxonomy, SCI pain can be grouped into a nociceptive and a neuropathic pain type. Within these groups, it can be further divided into subtypes (e.g. musculoskeletal or visceral pain, either at or below the lesion).

The questionnaire itself takes approx. 15 minutes to complete. I, depressive symptoms will be assessed by the Beck Depression Inventory (BDI II).


Proposed classification of pain related to spinal cord injury

Broad type
(Tier 1)

Broad system
(Tier 2)

Specific structures / pathology
(Tier 3)



Bone, joint, muscle trauma or inflammation
Mechanical instability
Muscle spasm
Secondary overuse syndromes



Renal calculus, bowel, or sphincter dysfunction, etc.
Dysreflexic headache


Above level

Compressive mononeuropathies
Complex regional pain syndromes


At level

Nerve root compression (including cauda equina)
Spinal cord trauma / ischemia (transitional zone, etc.)
Dual level cord and root trauma (double lesion syndrome)


Below level

Spinal cord trauma / ischemia (central dysesthesia
syndrome, etc.)

(adapted from IASP Taskforce on SCI Pain)