title: Pain and post-traumatic stress disorder symptoms during inpatient rehabilitation among operation enduring freedom/operation iraqi freedom veterans with spinal cord injury.
abstract: OBJECTIVE
  To examine the frequency of post-traumatic stress disorder (PTSD) symptoms and pain, and how PTSD symptoms were associated with pain severity ratings and the longitudinal course of pain during inpatient rehabilitation for spinal cord injury (SCI) among veterans of the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) conflicts.
  
  
  METHODS
  Longitudinal analysis of data gathered from electronic medical records.
  
  
  METHODS
  SCI specialty care centers within the Department of Veterans Affairs.
  
  
  METHODS
  Veterans of the OEF/OIF conflicts (N=87) who received inpatient rehabilitation for SCI and disorders at Department of Veterans Affairs SCI centers between May 2003 and October 2009.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  PTSD screening at start of rehabilitation and pain numeric rating scale measurements completed throughout rehabilitation. Cut-scores were used to categorize participants into 1 of 4 groups on the basis of scores at the start of rehabilitation: Pain and PTSD, Pain Alone, PTSD Alone, Neither Condition.
  
  
  RESULTS
  Comorbid pain and PTSD symptoms were more common than either condition alone, and nearly as common as not having either condition. Participants with pain at the start of rehabilitation (Pain and PTSD, Pain-Alone groups) showed declines in pain ratings over the course of rehabilitation. In contrast, participants in the PTSD-Alone group showed increasing pain over the course of rehabilitation.
  
  
  CONCLUSIONS
  Pain and PTSD symptoms may be more likely to manifest as comorbidities than as isolated conditions during inpatient rehabilitation. Assessment routines and care plans should be prepared with comorbidities as a foremost concern. It is advisable to screen for pain and PTSD at multiple time points during inpatient rehabilitation to detect new or emerging concerns.
authors.affiliation: Department of Veterans Affairs, Spinal Cord Injury and Disorders Services, VA Puget Sound Healthcare System, Seattle, WA, USA. philip.ullrich@va.gov
authors.forename: Philip M
authors.initials: PM
authors.lastname: Ullrich
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.forename: Linda
authors.initials: L
authors.lastname: Poggensee
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Burns
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000473:pathology* / Q000534:rehabilitation*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*