For veterans, both men and women, who have returned from Continual Afghanistan, researchers have blamed their increased exposure to recurring blasts, cognitive issues, and deep emotional impacts for the acute and chronic pain that they suffer from now.
The finding was discussed at the American Pain Society's annual scientific meeting.
"These Middle East conflicts, with their very high level of blast injury survivors, call for the military, the VA and the civilian health system to treat post-injury pain as a priority after military discharge to prevent pathophysiology, with a focus of providing effective pain control and rapid restoration of function and social networks to prevent disability and secondary negative health and personal consequences of chronic pain," said Rollin M. Gallagher, M.D. MPH, deputy national program director for pain management for the VA and clinical professor of psychiatry and anaesthesiology, Penn Pain Medicine, University of Pennsylvania.
These disorders are aggravated for some because of multiple tours of duty, especially those who are older and have families.
VA clinicians are now challenged to manage pain in blast survivors with one or several other consequences of blast, such as head injuries causing mild to severe TBI, physical disfigurement and social stigma, emotional trauma, and often post traumatic stress disorder (PTSD).
These problems are overlapped with evidence of sleep problems, substance abuse and depression, which make it harder to treat them with traditional interdisciplinary pain treatment.
The Veteran Administration plans to start cognitive behavioral therapy interventions targeting PTSD, pain, mild TBI, sleep and substance abuse, typically in combination, and with a physical training component.
"Our objectives are to maximize function and life adjustment, prevent symptom development or exacerbation, and reduce stress through a single team effort," said Dr. Clark, Ph.D., clinical director of the Veteran Administration's largest and most comprehensive pain management and rehabilitation program in Tampa, and associate professor, department of psychology, University of South Florida.