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.
- 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.
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: ANPT Outcome Measures Recommendations (EDGE)
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
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