“ Chronic pain should be assessed and treated along with other neurocognitive and neurobehavioral disorders such as memory deficits and depression . While we cannot assess the directionality of the relationship between pain and outcomes , the findings indicate that the presence of chronic pain after TBI is far from benign .”
Issue 33.2
Pain Is a Major Problem for Individuals with Traumatic Brain Injury
Chronic pain affects approximately 60 % of people living with traumatic brain injury ( TBI ), even up to 30 years after injury , according to new research published in The Journal of Head Trauma Rehabilitation ( JHTR ), the official journal of the Brain Injury Association of America .
“ This is the first study to examine the experience of chronic pain in a large TBI sample this far post-injury ,” explain Cynthia Harrison-Felix , PhD , FACRM , Co-Project Director of the TBI Model System at Craig Hospital in Englewood , CO , and colleagues . “ Pain status did not differ significantly across follow-up years . While our data are not longitudinal , it suggests that chronic pain occurs at varying points after injury , and may interfere with initial recovery and long-term , necessitating proactive pain assessment and treatment .”
Leveraging a large research network uncovers a high incidence of chronic pain after TBI The researchers surveyed patients who were being followed in the TBI Model Systems , a research program that includes the 18 U . S . rehabilitation centers in the study . All 3804 respondents had been hospitalized with moderate to severe TBI . Most were white ( 77 %) and male ( 75 %), and average time since injury was five years ( range , 1 – 30 years ).
The survey informed participants that chronic pain can be defined as “ persistent or recurring pain that lasts longer than three months . It includes headaches or pain anywhere in the body , which occurs more than half of the days over a three-month period .” When the study participants were asked specifics about their own pain , the key results were :
• 46 % reported current chronic pain , 14 % reported past chronic pain ( after TBI ), and 40 % reported no chronic pain
• 32.5 % of participants with current chronic pain reported constant pain
• Compared with participants who reported no chronic pain after TBI or only past chronic pain , those with current chronic pain had significantly worse results on all three outcome measures included in the survey : the Functional Independence Measure motor and cognitive subscores , the Disability Rating Scale , and the Glasgow Outcome Scale – Extended
Medications are the most frequently used treatments Medications , physical therapy , and home exercise programs were the pain treatments
“ Chronic pain should be assessed and treated along with other neurocognitive and neurobehavioral disorders such as memory deficits and depression . While we cannot assess the directionality of the relationship between pain and outcomes , the findings indicate that the presence of chronic pain after TBI is far from benign .”
most commonly reported . Medications were used by 91 % of participants with current chronic pain and had been used by 90 % of those with past chronic pain .
The least frequently reported treatment was comprehensive chronic pain rehabilitation . This finding “ suggests there may be an access issue given the proven benefit ,” Dr . Harrison-Felix ’ s group notes . Pain treatments known to be effective in other patient populations , such as psychotherapy and biofeedback , were not often reported .
“ Chronic pain should be assessed and treated along with other neurocognitive and neurobehavioral disorders such as memory deficits and depression ,” the researchers conclude . “ While we cannot assess the directionality of the relationship between pain and outcomes , the findings indicate that the presence of chronic pain after TBI is far from benign .” g
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