The Journal of Head Trauma Rehabilitation special issue on chronic pain
By Sravya Valiveti. This article was initially published in the 3/7/24 edition of our Concussion Update newsletter; please consider subscribing.
While this blog post covers research about moderate to severe traumatic brain injury (TBI) and its relation to chronic pain, we think it may have relevance to some patients with persisting symptoms after concussion.
UW Medicine researcher Dr. Jeanne Hoffman recently co-authored and published a series of 10 research papers with a team of researchers from across the country that explored the relationship between comorbidity factors and chronic pain outcomes in patients who have been hospitalized for TBI. The Journal of Head Trauma Rehabilitation decided to dedicate the entirety of its latest issue to chronic pain after TBI, featuring this series of papers. This topical issue was reported to be an exceptional achievement for the team, as all 10 of their research papers fill the current issue cover to cover.
A press release by UW Medicine describes the team’s survey findings that about 60% of the 3,800 patients from the TBI cohort reported current or previous chronic pain. Based on prior research, long-term chronic pain was found to be highly prevalent in those who have experienced traumatic brain injury, and those with a prior TBI not only experience higher rates of chronic pain but are also more likely to experience other comorbid conditions––such as chronic headaches accompanying the pain that can significantly interfere with their daily life and recovery process. The authors highlight that “TBI in the presence of comorbid chronic pain is significantly associated with greater disability, lower levels of community reintegration, and poor psychological health (depression and decreased satisfaction with life).” It was also reported that these significantly higher rates of persistent chronic pain persisted decades post-initial brain injury in this patient population.
The research team highlights that current treatments for managing long-term comorbid chronic pain have been inadequate and less effective, as 46% of the cohort have reported existing chronic pain. It’s even more imperative for providers to work with patients long-term to address the type or source of chronic pain that can range from neuropathic to pain originating from the site of brain injury to soft tissue to pain arising from the musculoskeletal system (interactions between bones and muscles). Additionally, experiencing pain from multiple comorbid conditions can amplify the burden of pain management and limit patients’ ability to manage daily life or function independently. Different types of pain or pain from other comorbidities reported by the patient can contribute to their existing chronic pain associated with TBI and complicate the situation for many patients who may not be experiencing much relief from treatments that they’ve already tried, thus impairing outcomes further. This complexity can make it challenging for providers to accurately address multiple underlying sources of pain and prescribe treatments that work well for those who have this overlap in pain conditions. As chronic pain associated with TBI is unique to each patient and highly complex, increasing early access to the proper treatment options that provide the most benefit can help mitigate the negative impact of pain on well-being and make the process of navigating chronic pain more manageable for the patient.