Background: Even though ample cross-sectional spinal cord injury (SCI)-related pain studies exist, patterns in the development and progression of SCI pain over time have been largely unexplored. Method: The current study examined the number of reported joint pain sites among persons with SCI across a 15-year span. In the present study, changes in pain were examined with regard to changes in physical independence, mobility, social integration, depression, and smoking. Results: Results showed that the number of reported pain sites increased with time regardless of level or completeness of injury. While physical independence, mobility, and social integration remained relatively stable despite increasing numbers of pain sites, increases in depressive symptoms emerged. Finally, smokers with SCI reported more pain sites than their nonsmoking counterparts. © 2007 Thomas Land Publishers, Inc.