Volume 49 Number 7, 2012
Pages 1127 — 1136
Abstract — The purpose of this study was to describe the pain experience in Operation Iraqi Freedom/Operation Enduring Freedom veterans with and without a history of mild traumatic brain injury (mTBI) who present to polytrauma clinics for evaluation and management. We sought to evaluate the relationship between a veteran’s history of mTBI and posttraumatic stress (PTS) on axial pain, head/headache pain, and pain interference. We performed retrospective chart reviews of 529 Iraq/Afghanistan veterans referred for evaluation at two Department of Veterans Affairs medical centers. Problems with head/headache, low back, and neck pain were frequently endorsed. Subjective pain interference was reported in 21% of patients without a history of mTBI, 31.9% of patients with a history of mTBI with disorientation only, and 36.1% of patients with a history of mTBI with loss of consciousness. Statistically significant differences existed between the mTBI groups on PTS symptom endorsement, and PTS was predictive of pain experience and interference. A history of mTBI with loss of consciousness predicted head/headache pain, but otherwise did not predict pain or pain interference. PTS was strongly related to the pain experience. Pain is common in polytrauma patients. PTS severity is strongly associated with both pain report and pain interference, with head/headache pain showing a unique association with a history of mTBI. Implications for evaluation and management of pain in this complex population are discussed.
Key words: back pain, headaches, loss of consciousness, mental health treatment, mild traumatic brain injury, OIF/OEF veterans, pain, pain interference, polytrauma, posttraumatic stress disorder, traumatic brain injury.
This article and any supplementary material should be cited as follows:
Romesser J, Booth J, Benge J, Pastorek N, Helmer D. Mild traumatic brain injury and pain in Operation Iraqi Freedom/Operation Enduring freedom veterans. J Rehabil Res Dev. 2012;49(7):1127-36.
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Last Reviewed or Updated Wednesday, October 24, 2012 12:25 PM