Washington – They call it the coming tsunami, veterans returning from Iraq who will suffer chronic pain years from now.
Get ready, military doctors are warning pain specialists – even as they hope that slowly improving battlefield pain control may stem the tide.
The idea: Block the agony faster, and the body’s pain network may not go into the overdrive that sets up the injured for lingering trouble long after they’re officially healed.
“It’s going to take the military to stop thinking of pain as a symptom, a consequence of war,” says Lt. Col. Chester “Trip” Buckenmaier III, an acute-pain specialist at Walter Reed Army Medical Center who is pushing for that change. “Pain really is a disease. If you don’t manage it early, it leads to serious consequences.”
At risk aren’t just troops who suffered severe wounds such as loss of a limb, but others with varying types of pain that goes untreated or undertreated.
“If you don’t ask, they don’t report (pain),” says Dr. Robyn Walker, a psychologist at the James A. Haley Veterans Affairs Hospital in Tampa.
Troops with traumatic brain injuries, a signature of the war, may not be able to express pain adequately. More common is a tough-it-out mentality, she says, a fear that admitting pain might block return to duty – or hesitancy because they know wounds could have been worse.
“Most pain doctors won’t see the severely injured. The VA will keep them,” says Dr. Michael Clark, chief of chronic-pain rehabilitation at the Tampa VA.
But other veterans eventually will seek community care, Clark warned an American Pain Society meeting last week: “This is going to impact you for decades to come.”
Doctors have long known that suppressing acute pain aids short-term recovery. But it’s also a factor in whether patients develop a long-term misery, chronic pain.
Nor is severe trauma the only concern. Clark is seeing lots of chronic knee pain; perhaps jumping out of trucks wearing 60-pound packs is too hard on the joints.
Then there are those high- powered blasts, where bystanders can walk away seemingly unscathed. Doctors are increasingly concerned that they may suffer nerve damage, perhaps signaled by headaches.
