Military PTSD Outlasts Physical Pain

Post traumatic stress disorder symptoms last longer than pain in combat injured veterans

(RxWiki News) Serious injuries can leave marks on both the body and the mind. Combat veterans with leg and arm injuries may feel a mental health burden long after physical pain eases.

Veterans Affairs researchers followed a group of military personnel that had sustained serious arm or leg injuries in combat for two years.

The researchers found that physical pain improved greatly after the first year, but mental health symptoms persisted for the two years of the study.

The authors suggested the use of mental health services along with physical rehabilitation for improved recovery. 

"Talk to a therapist about PTSD."

Rollin M. Gallagher, MD, MPH, professor of psychiatry and anesthesiology at the University of Pennsylvania and the deputy national program director for pain management in the Department of Veterans Affairs, led an investigation into the persistence of mental health disorders in veterans after experiencing a limb injury.

For the study, 227 military personnel who experienced a limb injury while in combat were interviewed over the course of two years.

A total of 83 percent had leg injuries, 34 percent of which involved an amputation. Nearly half of all leg injuries (43 percent) included both legs. Arm injuries were found in 49 percent of patients, with 9 percent resulting in an amputation.

Each participant was assessed for physical pain levels and mental health disorders every six months for two years.

The results showed that physical pain levels decreased over the course of the first year of the study and then remained steady over the second year.

Throughout the study, 14 percent of participants reported symptoms of depression, 14 percent reported symptoms of anxiety and 5 percent indicated they had thought about suicide.

Some symptoms of post-traumatic stress disorder (PTSD) were reported by 46 percent of patients, but higher levels and more severe PTSD symptoms were reported by 11 percent of patients. PTSD symptoms remained constant throughout the two years of the study. 

The authors concluded that physical pain levels showed the greatest improvement within the first three to six months after injury, but that mental health issues were consistently found throughout the study.

The authors recommended further investigations into effective physical pain care combined with psychological symptom care to help injured veterans cope with the trauma of injury  and readjust to life.

“Our research confirms that chronic daily pain, including neuropathic pain, continues to be a burden for limb-injured servicemen, that post-traumatic stress is a far more prominent feature of recovery than in other chronic pain populations, and that returning to meaningful role functioning in their lives is challenging for many,” said Dr. Gallagher in a press release.

This study abstract was presented at the American Academy of Pain Medicine 29th Annual Conference in Ft. Lauderdale, FL, April 11-14, 2013. These study results have not been published in a peer-reviewed journal.

The Department of Veterans Affairs, Rehabilitation Research and Developmental Service and the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. provided funding support for this project. The authors declared no conflicts of interest.

Review Date: 
April 11, 2013