Mehalick Melissa L, Glueck Amanda C
a Department of Neurotrauma, Operational and Undersea Medicine Directorate , Naval Medical Research Center , Silver Spring , MD, USA.
b Sports Medicine Research Institute , University of Kentucky , Lexington , KY, USA.
Brain Inj. 2018;32(11):1307-1314. doi: 10.1080/02699052.2018.1495339. Epub 2018 Jul 11.
In this review, we discuss the comorbidity of traumatic brain injury (TBI) and pain among civilians and military members, the common causes of pain resulting from TBI, and offer insight about the therapeutic management of TBI symptoms and pain. Traumatic brain injury (TBI) is a debilitating health problem and one of the most common post-TBI symptoms is pain, which can contribute to psychological issues such as Post-traumatic stress disorder (PTSD) and depression. Headache pain appears to be the most common type of pain that results from TBI, yet pain can also be more widespread. Managing TBI symptoms and pain simultaneously is difficult because extensive randomized control and clinical studies assessing the effectiveness of therapeutic approaches are lacking. Pharmacological agents such as antidepressants and Triptans and nonpharmacological therapies such as cognitive rehabilitation and physical therapies are commonly used yet it is unknown how effective these therapies are in the long-term. A combination of pharmacological and non-pharmacological therapies is often more effective for managing TBI symptoms and pain than either treatment alone. However, future research is needed to determine the most therapeutic approaches for managing the comorbidity of pain and TBI symptoms in the long term. This review offers suggestions for such future studies.
在本综述中,我们讨论了平民和军人中创伤性脑损伤(TBI)与疼痛的共病情况、TBI导致疼痛的常见原因,并就TBI症状和疼痛的治疗管理提供见解。创伤性脑损伤(TBI)是一个使人衰弱的健康问题,TBI最常见的症状之一是疼痛,它可能导致诸如创伤后应激障碍(PTSD)和抑郁症等心理问题。头痛似乎是TBI导致的最常见的疼痛类型,但疼痛也可能更为广泛。同时管理TBI症状和疼痛很困难,因为缺乏评估治疗方法有效性的广泛随机对照和临床研究。常用的药物如抗抑郁药和曲坦类药物,以及非药物疗法如认知康复和物理疗法,但这些疗法的长期效果尚不清楚。药物疗法和非药物疗法相结合通常比单独使用任何一种治疗方法更有效地管理TBI症状和疼痛。然而,需要未来的研究来确定长期管理疼痛和TBI症状共病的最有效治疗方法。本综述为这类未来研究提供了建议。