(P09-029-25) Poor Diet Quality Is Associated With Greater Neuropathic Pain Among People With Spinal Cord Injury

Objectives: Inadequate diet and chronic neuropathic pain (NeuP) are both highly prevalent in people with spinal cord injury (SCI). Poor diet quality has been associated with greater pain in the general population, possibly mediated by inflammation. However, the relationship between diet quality and pain in the SCI community is currently unknown. The study's objective was to test the hypothesis that poor diet quality is related to higher levels of NeuP in people with SCI.

Methods: Individuals with SCI completed validated self-report questionnaires regarding the presence and average intensity of their pain, and the average unpleasantness of their pain, during the past week (separate 0-10 numerical rating scales for each), as well as the severity of characteristics specifically associated with NeuP (NeuP Symptom Inventory; NPSI; 0-100), with higher scores indicating worse pain. Dietitian-guided 3-day food records were collected to determine diet quality via the 2015 Healthy Eating Index (HEI; 0-100), with higher scores indicating better quality. Other diet variables (e.g., vitamins and minerals) were evaluated as secondary metrics. Spearman’s rank-order correlations were used to assess relationships between pain and diet variables, with alpha set at 0.05 (uncorrected).

Results: The study sample (n=46) primarily consisted of males (75%), with about half (54%) with tetraplegia, a mean age of 40.7±11.5 y, a mean weight of 79.3±18.9 kg, and a mean HEI of 55.3±15.0. HEI was negatively correlated with NPSI (r=-0.322; p=0.042) but not associated with ratings of average pain intensity or unpleasantness (p >0.05). Average energy intake adjusted by body weight was positively correlated with average pain intensity rating (r=0.311; p= 0.042) and NPSI scores (r=0.294, p=0.047). Vitamin D (r=-0.328; p=0.039), magnesium (r=-0.323; p=0.042), and potassium (r=-0.334; p=0.035) were all negatively correlated with ratings of average unpleasantness (all, p≤0.042).

Conclusions: Our preliminary analysis suggests that less healthy eating patterns, including excess energy intake, are related to greater levels of pain in individuals with SCI. Poor diet after SCI may instigate an inflammatory environment, increasing pain susceptibility.

Funding Sources: National Institute for Disability, Independent Living, and Rehabilitation Research, South Florida Spinal Cord Injury Model System