A systematic review of the prevalence of musculoskeletal pain, back and low back pain in people with spinal cord injury

Disabil Rehabil. 2014;36(9):705-15. doi: 10.3109/09638288.2013.808708. Epub 2013 Jul 10.


Purpose: To review and summarise the prevalence of chronic back pain (CBP), chronic low back pain (CLBP) and chronic musculoskeletal pain (CMSKP) in people with spinal cord injury (SCI) and evaluate how pain is assessed.

Method: A systematic literature review between 1990 and 2012 in English language journals. Twelve databases were searched including CINAHL, Cochrane, Embase, PubMed and Science direct. Data were analysed using descriptive statistics and 95% confidence interval (CI).

Results: Eight studies fulfilled the inclusion criteria. Four reported on CMSKP, four on CBP and only two on CLBP. Among people with SCI and pain, the prevalence of CMSKP was 49% (95% CI: 44-55%), CBP was 47% (95% CI: 43-50%) and CLBP was 49% (95% CI: 44-55%). There were variations in both the pain classification systems used and the data collected. The type of pain reported in the back and low back areas could not be established due to insufficient evidence.

Conclusion: The main finding is that the prevalence of CMSKP, and more particularly CBP and CLBP are not sufficiently reported in SCI literature. Implications for Rehabilitation There is sufficient evidence, though modest in quality and quantity, to indicate that chronic musculoskeletal pain (CMSKP), back pain (CBP) and low back pain (CLBP) are common in people with spinal cord injury (SCI). This deserves consideration by health professionals treating such patients. Pain assessment, including BP and LBP, for people with SCI should become part of the overall clinical assessment and it is preferable that standardised pain assessment tools are used. Where people with SCI suffer from CMSKP, and particularly CBP and CLBP, further consideration should be made, likely to include posture, strengthening and seating as is referral for pain medication.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Back Pain / epidemiology*
  • Back Pain / rehabilitation
  • Humans
  • Low Back Pain / epidemiology
  • Musculoskeletal Pain / classification
  • Musculoskeletal Pain / epidemiology*
  • Musculoskeletal Pain / rehabilitation
  • Neuralgia / epidemiology
  • Pain Measurement
  • Prevalence
  • Spinal Cord Injuries / epidemiology*
  • Spinal Cord Injuries / rehabilitation