Understanding Pain in Individuals with Traumatic Brain Injury

  • Ajax Yang
  • Jason K. Ough
  • Devi E. Nampiaparampil


Traumatic brain injury (TBI) is a significant worldwide public health problem. TBI is usually caused by an external blunt or penetrating trauma to the head, skull, dura, or brain. Acceleration-deceleration injuries (i.e., whiplash) or coup-contrecoup injuries can also cause damage. The annual incidence of TBI in the United States has been cited as 1.7 million cases, but this is likely an underestimate due to underreporting and misdiagnosis, and does not take into account the increasing number of military patients with TBI. The public’s interest in concussions and chronic traumatic encephalopathy among professional football players has led to increased awareness about concussion and TBI in the United States.

TBI is a contributing factor in nearly one-third of all injury-related deaths in the United States. Total lifetime costs are estimated to be over $60 billion per year. The hallmark features of TBI include head injury with loss of consciousness or alteration of mental status. Consequences of TBI include cognitive deficits, mental health issues, as well as physical pain complaints. Chronic pain is a common complication of TBI and may be exacerbated by psychiatric conditions such as depression and posttraumatic stress disorder. In this chapter, we will emphasize a multidisciplinary approach, incorporating physical, pharmacologic, and psychological modalities for the treatment of pain associated with TBI. Further research into the pathophysiology and diagnosis of TBI and its complications may lead to improved treatments. Brain imaging technology used in mapping out areas of brain injury has demonstrated promising results. Physicians are able to direct neuromodulatory therapies targeting affected areas of the brain to reduce sequelae of TBI.


Traumatic brain injury TBI Chronic pain Posttraumatic headache Postconcussion syndrome 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ajax Yang
    • 1
  • Jason K. Ough
    • 2
  • Devi E. Nampiaparampil
    • 3
    • 4
    • 5
  1. 1.Department of Rehabilitation MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of AnesthesiologyKaiser Permanente San Rafael Medical CenterSan RafaelUSA
  3. 3.Department of Rehabilitation MedicineNYU School of MedicineNew YorkUSA
  4. 4.Metropolis Pain Medicine, PLLCNew YorkUSA
  5. 5.WNYW Fox 5 NYNew YorkUSA

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