The rigorous training and sacrifices that athletes endure to participate in the Olympic Games take a prominent position. For Paralympians and elite athletes with spinal cord injuries (SCI), evaluating chronic pain is crucial for their training and readiness to compete. Unfortunately, the origins of chronic pain are frequently misattributed to either acute injuries or issues resulting from overuse. Although the International Olympic Committee recognizes that data on pain management for Paralympians and disabled athletes is scarce, few studies have explored this significant issue.
With the Paris 2024 Paralympic Games approaching, the intense training and sacrifices made by athletes to participate in these games come into focus.
For Paralympians and high-performance athletes living with spinal cord injuries (SCI), understanding chronic pain is essential for effective training and competition. Yet, the causes of this chronic pain are often incorrectly linked to sudden injuries or overexertion. While the International Olympic Committee notes that there’s limited data on pain management among disabled athletes, there’s a lack of research addressing this concern.
Recent findings from UBC Okanagan underline the importance of developing more thorough assessment tools that assist SCI athletes in recognizing and articulating neuropathic pain.
Neuropathic pain arises from the nervous system and can lead to sensations of pain felt anywhere in the body. This type of pain typically manifests as burning, tingling, or shooting sensations but diagnosing it can be challenging for individuals with an SCI.
Dr. Kendra Todd, a graduate of the School of Health and Exercise Sciences, serves as a Senior Policy Analyst at Canada’s Office of Public Service Accessibility and coaches British Columbia’s Wheelchair Rugby team.
According to Dr. Todd, her recent study presents the first detailed account of how SCI athletes experience neuropathic pain and the difficulties they face in discussing it.
“Athletes generally possess heightened body awareness compared to relatively sedentary individuals, making them better able to pinpoint painful feelings,” Dr. Todd notes. “However, SCI athletes in this research struggled to articulate their neuropathic pain experiences. This often leads to misunderstandings and can hinder accurate diagnosis and injury management.”
Though not all individuals diagnosed with neuropathic pain characterize it as severe, accurately identifying the pain’s source is vital for determining the right treatment strategies. Participants in Dr. Todd’s study reported feeling pain but often described it using vague terms like indescribable, ambiguous, uncomfortable, and dislocated, indicating their struggle to pinpoint the exact source of their discomfort.
“While athletes in our research indicated they experienced moderate neuropathic pain, they found it challenging to convey their feelings without being presented with a list of symptoms,” she explains. “Effective identification and treatment of neuropathic pain is essential due to its debilitating nature and the risk of becoming resistant to treatment.”
The study, recently published in BMJ Open Sport & Exercise Medicine, emphasizes the necessity for sports medicine professionals and trainers to enhance their tools to include various standardized assessment methods, especially symptom-based questionnaires that can assist in recognizing signs of neuropathic pain. Additionally, they should become adept at interpreting patient narratives and examination results.
“Understanding neuropathic symptoms more clearly can greatly improve how we make early pain management decisions for athletes, especially those needing to reduce participation or facing delayed returns to their sport,” states Dr. Kathleen Martin Ginis, UBC Professor and Director of the Centre for Chronic Disease Prevention and Management, who supervised the study.
Dr. Martin Ginis highlights the importance of sharing effective practices with stakeholders to gain a clearer insight into the terminology used by athletes with SCI when they describe their neuropathic pain.
“It’s crucial for clinicians and trainers to be trained in recognizing the signs of neuropathic pain and to be skilled at interpreting what patients say during examinations,” she adds.
Dr. Todd concludes by stating that, while we expect all athletes to perform at their best, it’s vital to remember that those with SCI frequently contend with hidden and unclear pain.
“Most athletes with spinal cord injuries live with chronic pain, which is an important consideration as we support our Paralympians at the Games,” she remarks. “Effective management of neuropathic pain for SCI athletes is crucial for not only relieving discomfort but also encouraging participation in sports and ensuring their overall wellbeing.”
