Persistent pain is a long-term challenge after traumatic brain injury

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A recent study in the Journal of Head Trauma Rehabilitation sheds light on the enduring nature of chronic pain in individuals with traumatic brain injury (TBI).

This groundbreaking research, led by Cynthia Harrison-Felix, Ph.D., and her team at Craig Hospital’s TBI Model System, reveals that chronic pain affects about 60% of people with TBI, lasting even up to three decades post-injury.

This study is unique as it delves into the chronic pain experiences of a large group of TBI survivors, years after their injury.

The findings suggest that chronic pain can emerge at various points post-injury and may significantly hinder both initial recovery and long-term well-being. These insights underscore the need for early and ongoing pain management in TBI treatment.

The study analyzed data from 3,804 individuals who had experienced moderate to severe TBI. These participants were part of the TBI Model Systems, encompassing 18 U.S. rehabilitation centers.

Predominantly white (77%) and male (75%), these individuals reported on their experiences an average of five years after their injury, with a range extending up to 30 years.

Chronic pain, as defined for the study, includes persistent or recurrent pain lasting over three months.

The survey found that 46% of participants were experiencing current chronic pain, 14% had past chronic pain post-TBI, and 40% reported no chronic pain. Notably, 32.5% of those with current chronic pain described it as constant.

The impact of chronic pain on TBI survivors is profound.

Those with current chronic pain showed significantly worse outcomes in functional independence, disability ratings, and extended Glasgow Outcome Scales compared to those without chronic pain or those who only experienced it in the past.

Medications emerged as the most common treatment for chronic pain, used by over 90% of participants with either current or past pain. Physical therapy and home exercise programs were also frequently mentioned.

However, comprehensive chronic pain rehabilitation, despite its proven benefits, was seldom reported, suggesting possible barriers to access. Other effective treatments like psychotherapy and biofeedback were also underutilized.

This study highlights that chronic pain is a critical factor in the rehabilitation and quality of life of TBI survivors. It emphasizes the importance of incorporating pain assessment and treatment into the overall management of TBI-related health issues.

The researchers call for a more holistic approach, treating chronic pain alongside other neurocognitive and neurobehavioral disorders such as memory deficits and depression.

The study indicates that chronic pain following TBI is a significant issue, one that demands attention in both clinical practice and further research.

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For more information about pain, please see recent studies about why people with red hair respond differently to pain than others, and results showing this drug may relieve painful ‘long covid’ symptoms.

The research findings can be found in Journal of Head Trauma Rehabilitation.

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