As upper extremity (UE) function is critical to those with decreased function of the lower extremities, this study investigated the prevalence and patterns of pain in the UE among individuals with spinal cord injury (SCI)．

A university healthcare system database was searched for patients with accident related paraplegia, during a period spanning 17 years. Information regarding the level of injury was obtained. A questionnaire was sent with queries regarding medical status, demographics and pain. The data were reviewed to determine relationships of pain with age, gender, time since injury, completeness of injury and neurologic level of injury (NLI)．

Participants were 322 men and 129 women with an average age of 49.4 years. The average age at injury was 29.1 years. Pain was reported by 81%, with 61% reporting shoulder pain, 33% reporting elbow pain and 43% reporting wrist pain (of whom 25% had carpal tunnel syndrome). A multivariate analysis revealed that the risk of developing shoulder pain increased by three percent with each year of life, and by 2.4% for each year after injury. The rate of shoulder and elbow pain was higher among those with higher levels of injury (P＝0.005 and P＝0.022, respectively), while the rate of wrist pain was related to a longer time since injury (P<0.0007)．

This study of patients with paraplegia found that upper extremity joint pain is more prevalent the longer the time since, and the higher the level of, the injury to the spine.