Question
Where can i find the physiology of pain in SCI. I cannot quite get my head around why a family member suffers pain even though they are paralysed. (i work in the healthcare profession so are familliar with pain responses in the brain but cannot quite work it out, if their is damage to the spinal cord, is there nociception, the same as if their was an external stimuli?) Also, in the same token, how does massage give pain relief when she cannot feel it?????

Answer
Hi Claire- By have you asked a mouthful!  I'm not sure how well I understand it personally, but I will save the anecdotal stuff for later.  In the meantime I will tell you what I can:

First, though you may know this (I am just going from the wording of your question), paralysis is just not moving, doesn't necessarily entail not feeling.  There are people who have an "incomplete" SCI who can still feel what they cannot move- this happens because there are 2 kinds of nerve cells in your cord, movement and sensation.  Most often if you have trauma that affects one it also affects the other, but not always.
It turns out that roughly 1 in 3 SCI patients have persistent pain- and we know things like gunshot wounds are more likely to result in pain afterwards, or that lower injuries are more likely to have pain than higher ones.

Here is a link that talks a bit about pain folowing SCI and its causes:
http://www.spinalcord.uab.edu/show.asp?durki=21428

It's really very interesting, and I don't think I can elaborate much on the info there.  I can tell you one other thing I was told when in rehab: SCI is rarely a total cut-off, usually some part of the cord remains intact, right?  So some nerve impulses can get through the injured spot, it's just that sometimes after traveling through scar tissue and damage the impulse reaches the brain as a garbled message-- does that make sense?

Here's a couple of weird anecdotal things, in case you're interested- if I see a bee fly past me and disappear from my sight around my legs, I feel like I have been stung.  This is completely made up, I have not been stung, yet my brain takes my concern of the missing bee and creates the exact same feeling.  Right now, sitting here, if I think "my right foot hurts, my right foot hurts" I can feel pain in my foot.  I can't do it in my arms, which I can feel.  What do you suppose that is??
Also, again anecdotally, have you ever noticed that the sensations people feel after injury are more often the unpleasant ones?  If someone massages my back, I do not feel the good feeling.  I may experience relief if they loosen the muscles that have been tense (the tension making me tired or making other muscles work more to compensate- this is what would explain the example in your question.  We are all still connected to all those bones and muscles even if we can't feel them, and they still can make us tired or cause our feeling parts pain-- it's just that the signal doesn't get from the tense muscle to the brain directly, due to damage.  It has to travel in a more circuitous route.) Yet if my back is tired from being in the chair all day, I sure do feel that!  Why would this be the case- are negative sensations carried by more nerves?  Or are these nerves deeper or harder to damage?

So, that's about all I know, plus a question or two that I'd like answered one of these days!  Let me know if the combination of this rather rambling answer and the info at that link are helpful- and, of course, if you have more questions or if I have left something out, please do write in again, deal?
Thanks very much-
Leslie