Determining the management of pain in people with spinal cord injury by physiotherapists in South Africa.
Bernice James, Mokgadi K Mashola, Diphale J Mothabeng
PMID 35937093WHAT IT FOUND
South African physiotherapists most commonly use TENS, exercises, and joint mobilisations for spinal cord injury pain.
They rarely choose treatments based on cost, despite high financial barriers for patients.
Key findings
01TENS was the most commonly used modality (29.8%), followed by exercises (27.7%) and joint mobilisations (21.3%).
02The majority of physiotherapists did not consider the cost of treatment when selecting a modality.
03Most participants had less than 10 years of experience in spinal cord injury and treated fewer than 10 people with SCI per month.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The response rate was very low (10% of the anticipated sample), and the authors caution against generalising the results to all physiotherapists in South Africa. Most participants had little experience in spinal cord injury rehabilitation (less than 10 years in the field) and did not have a special interest in SCI pain, suggesting the findings may reflect generic pain management rather than SCI-specific protocols. The study used convenience sampling via online platforms, which may have biased results toward younger, tech-savvy, or more interested therapists. The survey did not specify the parameters or dosages of the treatments used (e.g., TENS frequency, exercise intensity).
Declared interests
No specific funding source or conflict of interest declaration is provided in the text.
The easy way to misread this
Do not interpret these findings as evidence that TENS, exercises, or joint mobilisations are effective for spinal cord injury pain. This is a descriptive survey of what therapists do, not a trial of what works. Additionally, the low response rate and lack of SCI-specific expertise among respondents mean these practices may not represent the standard of care for complex SCI pain.