Prevalence of Upper Limb Pain in Spinal Cord Injury: A Systematic Review

A systematic review was undertaken to evaluate and critically appraise literature pertaining to prevalence and treatment of upper limb pain in the spinal cord injured (SCI) population using manual wheelchair. Data extraction tables were compiled, then an in-depth data on the types of injury, level of injury, type of wheelchair used, type of treatment sought and the impact on Activities of Daily Living were recorded. A Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies tool was used to critically appraise the quality of studies included in this review. 994 papers in total were screened, 46 full text studies were assessed with 14 studies included in the final synthesis: four cohort studies and ten cross-sectional studies. Shoulder pain was the most common type of pain reported (30–71%) followed by wrist, hand, and elbow. Functional limitations reported because of upper limb pain included interference with mobilizing, transferring, and Activities of Daily Living, primarily personal care tasks. There is clear evidence that upper limb pain is prevalent in the SCI manual wheelchair using population which impacts on functional tasks. Further research is required to explore the perceptions of those with upper limb pain and techniques used to manage pain.