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Cited by 18Pain Management and TreatmentPain Mechanisms and TreatmentsTraumatic Brain Injury Research

Pain in an era of armed conflicts: prevention and treatment for warfighters and civilian casualties

George, E., Elman, I., Becerra, L., Berg, Sheri, Borsook, D.·2016·Progress in Neurobiology
DOI 10.1016/j.pneurobio.2016.04.002
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Abstract

Chronic pain is a common squealae of military- and terror-related injuries. While its pathophysiology has not yet been fully elucidated, it may be potentially related to premorbid neuropsychobiological status, as well as to the type of injury and to the neural alterations that it may evoke. Accordingly, optimized approaches for wounded individuals should integrate primary, secondary and tertiary prevention in the form of thorough evaluation of risk factors along with specific interventions to contravene and mitigate the ensuing chronicity. Thus, Premorbid Events phase may encompass assessments of psychological and neurobiological vulnerability factors in conjunction with fostering preparedness and resilience in both military and civilian populations at risk. Injuries per se phase calls for immediate treatment of acute pain in the field by pharmacological agents that spare and even enhance coping and adaptive capabilities. The key objective of the Post Injury Events is to prevent and/or reverse maladaptive peripheral- and central neural system's processes that mediate transformation of acute to chronic pain and to incorporate timely interventions for concomitant mental health problems including post-traumatic stress disorder and addiction We suggest that the proposed continuum of care may avert more disability and suffering than the currently employed less integrated strategies. While the requirements of the armed forces present a pressing need for this integrated continuum and a framework in which it can be most readily implemented, this approach may be also instrumental for the care of civilian casualties.

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  • Patients whose partners have avoidant and anxious attachment styles are more likely to report greater pain and lower well-being.

    “Patients with partners showing avoidant and anxious attachment styles are more likely to report increased pain and decreased well-being 103, 124–127.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [127]

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Authors
George, E., Elman, I., Becerra, L., Berg, S., & Borsook, D.
Affiliations
Harvard University (US)
Corresponding author
Borsook, D.
ORCID
Venue
Progress in Neurobiology
Publisher
Elsevier BV
Published
2016-06
Volume
141
Pages
25-44
ISSN
0301-0082 (ISSN-L)
DOI
10.1016/j.pneurobio.2016.04.002
OpenAlex
W2341035808
Cited by
18
References
323
Citations by year
2025: 2 · 2024: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 3
FWCI
0.56
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Progress in Neurobiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Neurological Disorders and Stroke (K24NS064050)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
chronic pain, war injuries, military personnel, civilian casualties, pain prevention, pain management, resilience, post-traumatic stress disorder, addiction, acute pain management, central sensitization, peripheral sensitization, continuum of care
MeSH terms
Armed Conflicts, Brain, Humans, Military Personnel, Neural Pathways, Pain, Risk Factors, Stress, Psychological, Warfare, Wounds and Injuries

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