Special edition of Journal of Head Trauma Rehabilitation focuses on pain and TBI

People with traumatic brain injuries (TBI) who also have chronic pain tend to have more disability, worse psychological health, and greater difficulty reintegrating into the community. In people with TBI, pain can come from a variety of problems, including pain related to the TBI itself, soft tissue or musculoskeletal pain, and neuropathic pain and cognitive difficulties are seen as a significant barrier to receiving chronic pain treatment. Addressing chronic pain in individuals with TBI has the potential to improve health outcomes and quality of life. Addressing chronic pain in those with TBI is especially important given the current focus on opioid addiction in the United States. 

In the January/February 2024 edition of the Journal of Head Trauma Rehabilitation, 10 papers explore results from a multicenter study funded by NIDILRR examining chronic pain after TBI. This study leverages the TBI Model Systems National Database, which includes the UW TBI Model System. The TBI Model Systems National Database is the largest longitudinal study of TBI in the world. 

Jeanne Hoffman, PhD, Professor, co-lead the effort with two other colleagues and these three have written a preface to the topical issue that introduces the themes of these papers, which include: 

• An examination of the prevalence of chronic pain after TBI, which remains high over time postinjury
• A paper highlighting the  increase in psychological health distress (posttraumatic stress, anxiety and depression) and poorer sleep in those with TBI and comorbid chronic pain. 
• Articles that describe risk factors and modifiable factors associated with extreme responses to pain intereference on daily life and perceived improvement of pain, as well as the relationship between extreme pain responses and psychosocial outcomes. 
• An examination of the predictors for chronic headache after TBI.
• A paper on how opiate misuse and marijuana affect behavioral health after TBI. 
• Two articles focusing on access to high-quality chronic pain care for those with TBI, including provider-perceived facilitators and barriers to care and provider perspectives on those barriers and facilitators, as well as a paper exploring stakeholder-recommended strategies to overcome barriers to care. 

Hoffman is an author on all of these papers, except for the paper on opiates and marijuana use and TBI, which was co-written by Amy Starosta, PhD, Assistant Professor, and colleagues from other institutions.