“Challenges and facilitators—navigating in the landscape of spinal cord injury neuropathic pain”—a qualitative study on the use of prescribed drugs

Study design A qualitative study with an emergent design using semi-structured interviews in focus groups. Objectives To explore the expectations, experiences and desires among individuals who are prescribed drugs for spinal cord injury (SCI) neuropathic pain (NP). Setting SCI rehabilitation centre. Methods Eighteen informants with SCI and NP were enrolled. The informants originated from large and small cities in southern Sweden. Data were collected in focus groups consisting of 4–5 individuals in four separate sessions. An emergent design was employed using an interview guide containing open questions. The interviews were transcribed verbatim and data were analyzed according to qualitative content analysis. Results A model of three themes emerged: “Balancing between pain and side-effects” described the difficult choices the informants had to make between drugs and their unwanted side-effects and pain, “Desiring competence and structure in pain management” described the informants wishes regarding pain management and “From hope to personal solutions” described the process from hope of total pain relief from drugs to the development of personal strategies. Conclusions There is a great need for improvement of SCI-related neuropathic pain management since recommended drugs are insufficiently effective and accompanied by severe side-effects that impact quality of life but also due to structural limitations and physicians’ lack of competence in pain management.