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Aim

Mild traumatic brain injury and pain in Operation Iraqi Freedom/ Operation Enduring Freedom veterans. Jennifer Romesser, PsyD; Jane Booth, PhD; Jared Benge, PhD; Nicholas Pastorek, PhD; Drew Helmer, MD. Aim

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Aim

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  1. Mild traumatic brain injury and pain in Operation Iraqi Freedom/ Operation Enduring Freedom veterans Jennifer Romesser, PsyD; Jane Booth, PhD; Jared Benge, PhD; Nicholas Pastorek, PhD; Drew Helmer, MD

  2. Aim • Describe pain experience in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans with and without mild traumatic brain injury (mTBI) history who present to polytrauma clinics for evaluation and management. • Relevance • 12%–19% of OIF/OEF soldiers sustained mTBI. • While most completely recover, small percentage report persistent postconcussive symptoms (physical, cognitive, emotional). • Pain is quite commonly reported by those with mTBI.

  3. Methods • Retroactive chart reviews of 529 OIF/OEF veterans referred for evaluation at two Department of Veterans Affairs medical centers.

  4. Results • Problems with head/headache, low back, and neck pain were frequently endorsed. • Subjective pain interference reported in: • 21% of patients without mTBI history. • 31.9% of patients with mTBI history with disorientation only. • 36.1% of patients with mTBI history with loss of consciousness. • Posttraumatic stress predicted pain experience and interference, while head/headache pain showed unique association with mTBI history.

  5. Conclusion • Pain is one of the most complex facets of health to assess and treat. • In returning combat veterans, this complexity is compounded by frequent comorbidities such as mTBI and PTSD. • Our results reinforce growing consensus that comprehensive biopsychosocial approach to primary care of returning combat veterans may enhance detection, characterization, and treatment of comorbid physical and psychological conditions.

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