RehabMeasures Instrument
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  2. International Spinal Cord Injury Pain Classification

International Spinal Cord Injury Pain Classification

Last Updated

Purpose

The ISCIP classifies pain after SCI in three tiers according to type of pain and pain source. The ISCIP is a system for classifying type of pain rather than a true outcome measure that can measure change in pain over time.

Link to Instrument

instrument details

Acronym ISCIP

Cost

Free

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Spinal Injuries

Key Descriptions

  • Each area of pain is classified into three tiers (Bryce et al, 2012b):
  • Tier 1) Type of pain: nociceptive pain, neuropathic pain, other pain, and unknown pain
  • Tier 2) Subtype of pain
    A) Nociceptive pain is categorized as: musculoskeletal pain, visceral pain, or other nociceptive pain
    B) Neuropathic pain is categorized as: at level SCI pain, below level SCI pain, or other neuropathic pain
  • Tier 3) Primary pain source and pathology, if known
  • Classification of pain is determined by interview, examination, and imaging of the person with SCI.

Number of Items

3 tiers

Time to Administer

Variable 

Required Training

No Training

Instrument Reviewers

Initially reviewed by Rachel Tappan, PT, NCS, Eileen Tseng, PT, DPT, NCS and the SCI EDGE task force of the Neurology Section of the APTA in 3/2012

ICF Domain

Body Structure

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

LS

LS

LS

 

Recommendations based on SCI AIS Classification: 

 

AIS A/B

AIS C/D

SCI EDGE

LS

LS

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

SCI EDGE

No

No

Yes

Not reported

Considerations

  • The International Spinal Cord Injury Pain Classification (ISCIP) may be useful as a classification system for identifying types of pain after SCI. However, the clinical relevance of these pain subtypes has not been established with respect to: 
    • The identification of the prognosis for improvement in the pain with or without treatment
    • The identification of appropriate treatment for the pain
    • The impact of the pain on quality of life after SCI

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Spinal Injuries

back to Populations

Interrater/Intrarater Reliability

SCI:

(Bryce et al, 2012a) 

  • 56 members of the American Spinal Cord Injury Association (ASIA) and the International Spinal Cord Society (ISCoS) completed classification of pain presented in over 100 vignettes. The number of correct classifications made using experts’ type designation of criterion was 65.2% (strict criteria) to 85.4% (relaxed criteria from initial determination).

Content Validity

SCI: 

(Bryce et al, 2012b) 

  • ISCIP was developed by consensus of an international group of clinicians and researchers with expertise in pain after SCI. This classification system incorporated components of previous pain classification systems as determined appropriate by expert consensus.

Face Validity

See Content Validity

Bibliography

Bryce, T. N., Biering-Sorensen, F., Finnerup, N. B., Cardenas, D. D., Defrin, R., Ivan, E., . . . Dijkers, M. (2012). International Spinal Cord Injury Pain (ISCIP) Classification: Part 2. Initial validation using vignettes. Spinal Cord, 50(6), 404-412. doi: 10.1038/sc.2012.2 Find it on PubMed

Bryce, T. N., Biering-Sorensen, F., Finnerup, N. B., Cardenas, D. D., Defrin, R., Lundeberg, T., . . . Dijkers, M. (2012). International spinal cord injury pain classification: part I. Background and description. Spinal Cord, 50(6), 413-417. doi: 10.1038/sc.2011.156 Find it on PubMed

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