{
  "abstract": "Chronic pain affects most individuals with spinal cord injury (SCI) and frequently impairs daily function, and nearly half experience neuropathic pain. Neuropathic pain is commonly thought to develop months after injury and to persist once established. These views rest on classifying each patient as having neuropathic pain or not, although patients often report several pains. The same binary label is the usual target of prognostic and biomarker studies that aim to predict life-limiting pain. We tracked up to three of the worst pains per interview from injury to one year in 140 TRACK-SCI participants, using the DN4 interview (DN4i, threshold 3). Within three days of injury, half of all pain areas and three quarters of participants met the threshold, and pain-area prevalence changed little over the year. Individual pains, however, often changed. Only a third remained above the threshold throughout, one third resolved or fluctuated, and pains in the same person often followed different courses. At more than half of interviews with several pains, one pain met the threshold while another did not, so that the patients classification depended on the pain considered. We therefore derived a threshold-free Pain Composite Score from the DN4i items and pain intensity. The items formed a single dimension, and the composite was associated with sleep and mood interference whereas the binary classification was not. Neuropathic pain after SCI thus appears early, does not invariably persist, and differs between a persons pains, and graded pain-level measures may offer a more stable target for predicting life-limiting pain.\n\nSummaryNeuropathic pain after spinal cord injury appears early and does not always persist. A threshold-free score, unlike binary classification, tracks how pain limits daily life.",
  "abstract_shown": true,
  "affiliations": [
    "Weill Institute for Neurosciences, Brain and Spinal Injury Center (BASIC), University of California San Francisco (UCSF), San Francisco, CA, USA"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "name": "J. H. Gumbel"
    },
    {
      "name": "E. Mendoza"
    },
    {
      "name": "M. Arellano"
    },
    {
      "name": "J. R. Huie"
    },
    {
      "name": "D. D. Hemmerle"
    },
    {
      "name": "L. U. Pascual"
    },
    {
      "name": "V. Singh"
    },
    {
      "name": "A. V. Keller"
    },
    {
      "name": "X. Bradfield"
    },
    {
      "name": "P. R. Weinstein"
    },
    {
      "name": "J. C. Bresnahan"
    },
    {
      "name": "M. S. Beattie"
    },
    {
      "name": "A. R. Ferguson"
    },
    {
      "name": "J. L. K. Kramer"
    },
    {
      "affs": [
        0
      ],
      "name": "N. Kyritsis"
    },
    {
      "name": "TRACK-SCI Investigators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/etey7s0dcx26z.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.21.26366160",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366160v1.full",
  "id": "etey7s0dcx26z",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366160v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "pain medicine"
    ],
    [
      "openalex",
      "2734|Spinal Cord Injury Research"
    ]
  ],
  "openalex": "W7223444888",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366160v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/etey7s0dcx26z.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:42Z",
      "native_id": "10.64898/2026.10.21.26366160",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366160v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:pain medicine",
      "subfield": "surgery"
    }
  ],
  "title": "Trajectories and characteristics of pain in the first year after spinal cord injury: a TRACK-SCI study",
  "title_text": "Trajectories and characteristics of pain in the first year after spinal cord injury: a TRACK-SCI study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:50Z",
  "url": "https://research.draconitic.com/paper/etey7s0dcx26z",
  "venue": "medRxiv",
  "versions": []
}