How does aging affect pain after SCI?

Author: SCIRE Community Team | Reviewer: Patricia Mills | Published: 12 April 2017 | Updated: 18 October 2017, 10 October 2024

Watch SCIRE’s video about managing pain as you age.

Most people are familiar with the increase in aches and pains as they age. The gradual weakening and degeneration of the muscles, bones, ligaments, and tendons that comes with aging can eventually result in pain. However, the early stages of this degeneration do not usually have obvious symptoms. Pain can also happen because of other health conditions/disease (e.g. cancer, arthritis). Levels of pain can also be affected by mood, stress, and social support of family and friends.

Nerve (or neuropathic) pain is the most common type of pain after an SCI. There is some evidence that in general, neuropathic pain is stable as people with SCI age. However, experiences of neuropathic pain for people with SCI are incredibly varied and individual. Over time, one may experience increases, decreases, or new neuropathic pain.

Musculoskeletal pain is caused by problems in the muscles, joints or bones. It is a common problem for all people as they get older, including those with SCI. Most people aging with SCI experience increased musculoskeletal pain in the upper extremities (shoulder and arm). Other common pain spots include the elbows, wrists, and hands. Issues with posture and seating can cause neck and back pain.

Overuse injuries develop with age from many years of transfers, pressure relief maneuvers, wheelchair use, and other movements that require weight-bearing and repetitive strain. Because the upper extremities are not designed for such a high physical load, people develop injuries (e.g., tendonitis, bursitis) and pain from overuse.

Research shows that on average, people with SCI experience more arthritis and joint breakdown in the shoulder than the general population.

Pain is also commonly caused by other aging-related health conditions like osteoarthritis of joints beyond that described of the shoulder, skin breakdown, and constipation, etc.

Refer to our article on Shoulder Injury and Pain for more information!

To manage changes in musculoskeletal pain from aging with SCI, consult with your doctor, as well as physical and occupational therapists. They can conduct an injury assessment and help find ways to reduce and prevent pain.

Strategies may include:

• Modifying and optimizing movements and wheelchair skills to prevent injury and reduce pain.
• Strength exercises and stretching to stabilize the shoulder joint and improve muscle imbalances.
• Changes in use of assistive devices and technology to prevent further injury/pain and rest the affected joints/muscles.
• Changes in the work and home environment to reduce effort and pain in daily activities.
• Changes in wheelchair setup for propulsion efficiency and ease.
• Medication to relieve pain.
• Cognitive behavioral therapy and mindfulness.

If experiencing a change in neuropathic pain, consult with a health care provider to determine together what may be causing the change and how to manage it.

Refer to the “What physical treatments are used for pain after SCI?”, and “What psychological and mind-body therapies are used for pain after SCI?” sections above for more information on managing pain.