The relationship between pain and mood following spinal cord injury

Objectives: To explore the relationship between pain and mood during spinal cord injury rehabilitation, and to discuss clinical implications to optimize rehabilitation outcomes.

Design: Repeated measures, retrospective cohort study.

Setting: Tertiary care, spinal cord injury rehabilitation center.

Participants: Patients (N?=?509) who completed both Needs Assessment Checklist (NAC) 1 and NAC2 between February 2008 and February 2015.

Interventions: Not applicable.

Outcome measure: Pain ratings (0–10) and mood scores (0–24) were obtained from the Needs Assessment Checklist (NAC). NAC1 is completed within 4 weeks post-mobilization and NAC2 upon the patient moving to the pre-discharge ward.

Results: There were statistically significant improvements in both pain and mood from NAC1 to NAC2. There were significant correlations between pain and mood at both NAC1 and NAC2 (a decrease in pain was associated with an improvement in mood). Individuals who reported that pain interfered with their rehabilitation had higher pain scores and lower mood scores at both NAC1 and NAC2.

Conclusions: Pain and mood evidently interact following spinal cord injury, and the nature of this relationship is complex. The current study provides some support for the bidirectional causality hypothesis, suggesting that pain and mood exert an effect upon each other. It is important to address pain and psychological issues early and together in the post-injury phase to optimize rehabilitation outcomes.