A Comparison of Neuropathic Pain Experiences Among Paralympic versus Recreational Athletes with Spinal Cord Injury

Abstract

Abstract Background Individuals with spinal cord injury (SCI) report high levels of neuropathic pain. Current treatment options are primarily pharmaceutical, despite their limited effectiveness. Exercise may reduce neuropathic pain among persons with SCI, however, the optimal dose of exercise required to elicit analgesic effects remains unknown. The purpose of this study was to compare neuropathic pain intensity, pain catastrophizing, use of coping strategies, and positive affect and well-being among Paralympic versus recreational athletes with SCI who experience chronic neuropathic pain. Forty-seven athletes with SCI (25 Paralympic, 27 recreational) completed the International SCI Pain Basic Data Set, Douleur Neuropathique-4, coping strategies questionnaire, pain catastrophizing scale, SCI-quality of life assessment and a structured interview. Results Paralympic athletes reported significantly greater neuropathic pain (p = 0.032) and positive affect and well-being (p = 0.047) than recreational athletes. No other comparisons were significant (ps > 0.09). Significant positive correlations were observed between neuropathic pain and total minutes of moderate-intensity exercise (r = 0.335, p = 0.023) and average duration of moderate-intensity exercise sessions (r = 0.375, p = 0.010) over the past week. Conclusions The results suggest that frequent moderate- to- high intensity exercise may exacerbate neuropathic pain sensations for persons with SCI. Paralympic athletes are able to continue exercising at greater volumes than recreational athletes despite experiencing greater neuropathic pain. Research should investigate psychosocial and physiological mechanisms by which exercise may influence neuropathic pain to explain how Paralympic athletes with SCI are able to continue exercising while maintaining positive affect despite poor neuropathic pain.