By Kory McHenry and Kenneth McHenry, M.D.

Illustration by Mark H. Adams

The late Dr. Patrick Wall found that about one in 15 SCI patients has central pain. The bizarre burning occurs only where the cord injury is incomplete. Electric shocks or muscle pain may also occur. The preservation of sensation may be very slight, but some nerve function is necessary to maintain central pain. Some relief may be found in opiates (opioids), tricyclic antidepressants, or anticonvulsants (see sidebar, p. 34). Most patients can still wear clothing and have only mild muscle pain.

Of people with SCI who experience central pain, about a quarter have more severe pain, which responds poorly to therapy, but they are clearly better off on medication than off. They tend to have more gut or bladder pain and function.

In the remainder, the pain may reach such severity that the touch of clothing is unbearable and no medication or therapy is of significant benefit. This last group is much more likely to have sought radical pain treatment. As might be expected, they are also the most depressed