Article

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.

Langue : ANGLAIS