Comparison of pain and emotional symptoms in soldiers with polytrauma: unique aspects of blast exposure.
OBJECTIVE
To compare the physical and emotional presentation and pain treatment outcomes of service members who sustained polytrauma secondary to blast with those of soldiers injured by other means.


METHODS
Retrospective medical record review.


METHODS
One of four Veterans Affairs multidisciplinary inpatient Polytrauma Rehabilitation Centers. One hundred twenty-eight Operation Enduring Freedom and Operation Iraqi Freedom military personnel with serious polytrauma injuries and concomitant pain categorized into three groups based on type of injuries: blast injuries, combat injuries other than blast, and noncombat, nonblast injuries.


METHODS
Intensive, interdisciplinary inpatient rehabilitation and pain treatment.


METHODS
Pain intensity ratings; Functional Independence Measure scores; Rancho Los Amigos levels; and opioid analgesic doses.


RESULTS
Service members injured via blast demonstrated a broader spectrum of physical injuries, higher levels of admission and discharge opioid analgesic use, reduced improvement in pain intensity following treatment, and much higher rates of posttraumatic stress disorder and other psychiatric diagnoses than those injured via other means.


CONCLUSIONS
Blast injury may be associated with differential physical, emotional, and pain-related symptoms that pose increased challenges for successful treatment.
Chronic Pain Rehabilitation Program, James A. Haley Veterans Affairs Hospital, Tampa, FL 33612, USA. Michael.Clark8@va.gov
Michael E
ME
Clark
Robyn L
RL
Walker
Ronald J
RJ
Gironda
Joel D
JD
Scholten
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001753:Blast Injuries / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
D000701:Analgesics, Opioid