The pain you can’t see: Neuropathic pain after spinal cord injury
A common misconception is that someone who has a spinal cord injury (‘SCI’) is completely numb from the level of their injury down. While that might be the case for some people living with SCIs, for others, the opposite is often true. Many of our clients, whether they have a complete or incomplete injury, live with neuropathic pain that can be just as life-altering as the loss of movement itself.
What is neuropathic pain?
Neuropathic pain is caused by damage to the nerves themselves rather than the muscles, bones or organs. The nerves connecting the site of injury to the brain, once damaged, can cause the nervous system to send chaotic or exaggerated pain signals – even in body parts with little or no sensation otherwise.
Studies have found that neuropathic pain affects over half of all people living with an SCI. Pain conditions following SCI is something that we have learnt a great deal about over the years, both from the literature and medical experts, but more importantly from listening carefully to our clients describe their lived experience of it.
How our clients describe it
Everyone experiences neuropathic pain differently, making it difficult to diagnose and treat. I’ve had clients describe it as stabbing, intense burning, or like an electric shock shooting through the affected limb. One client put it more simply: it’s like an awful toothache.
For some clients, the pain is intermittent. For others, it is constant and may not respond to treatment at all. Whatever the variation, neuropathic pain takes a toll – not just physically, but emotionally. Sleep, mobility, mood and the ability to work can all be affected.
Why is it overlooked?
Pain, unlike paralysis or mobility aids, can’t be seen. When someone is mobilising in a wheelchair, it is generally understood that there has been a serious injury. What is less visible, and much less understood, is that same person may be dealing with relentless nerve pain in a limb they can barely move, or worse, one they have no sensation in but which still causes them agony.
Correctly identifying the source of someone’s pain is paramount. Confusing neuropathic pain with musculoskeletal pain (pain that affects your bones, joints, ligaments, or tendons) for example, can lead to delays in getting the right support and could leave patients feeling disheartened with their rehabilitation.
Why this matters in a legal context
Understanding the true impact of our clients’ neuropathic pain is essential. It influences the compensation needed to fund pain management, psychological help, adapted equipment, care, and specialist treatments like spinal cord stimulators. Getting this right from the outset means our clients aren’t simply compensated for the injury itself, but for the lasting reality of living with it.
As a team we stay closely engaged with the research in this area. Spinal research charities carry out vital work to better understand and treat neuropathic pain, and it’s something we’re proud to support.
If you or someone you know is living with a spinal cord injury, including neuropathic pain, and would like to find out what support or compensation might be available, our Spinal Injury team is here to listen.
