Musculoskeletal Pain

In the acute setting following injury, nociceptive pain arises from damage to structures including bone, ligaments, muscles, intervertebral disks, and facet joints. The pain is generally located in the region of preserved sensation close to the site of spinal injury, although it may radiate. People with incomplete SCI (where spinal cord pathways remain partially intact) also experience mus-culoskeletal pain below the neurological level. Chronic musculoskeletal pain may occur with overuse or abnormal use of structures, such as the arm and shoulder.15'16 For mobility reasons, this type of nociceptive pain is very common in people with paraplegia and much less common in people with tetraplegia.17 Muscle spasm pain is another type of musculoskeletal pain commonly seen in people with incomplete injuries. For a full discussion of painful spasticity, please refer to Chapter 33, Management of painful spasticity.

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