Pain care urged as a priority for wounded, returning veterans

Physicians are called upon to stop pain to prevent lasting changes in the nervous system and a downward spiral toward disability.

By Susan J. Landers, AMNews staff. Dec. 3, 2007.

Washington -- Wounded veterans returning from Iraq and Afghanistan are surviving injuries that would have been fatal in earlier wars. That's the good news. But these serious wounds also are causing a great deal of pain, which, if untreated, can trigger a cascade of life-disrupting changes, according to pain experts speaking at an Oct. 30 Capitol Hill briefing.

Without fast and effective pain relief, the many returning vets could find it difficult to work, sleep and have social relationships, pain experts said.

There are nearly 700,000 veterans of fighting in Iraq and Afghanistan. Among them are 200,000 who already are receiving care at Dept. of Veterans Affairs facilities. Given these numbers, primary care physicians likely will be called upon to treat this group of patients. They may participate in collaborative care models led by pain specialists, said Rollin M. Gallagher, MD, MPH, director of pain services at the Philadelphia VA Medical Center.

Dr. Gallagher wants to see a major effort to link primary care, pain specialists, social workers and others to meet this need. Pain is a common problem, and its solution will depend on good primary care, because there are not enough specialists to go around.

"We want to avoid having veterans sent from one specialist to another without getting good pain treatment," Dr. Gallagher said.

The briefing was sponsored by the American Pain Foundation, a nonprofit organization based in Baltimore. A grant from Endo Pharmaceuticals, a Chadds Ford, Pa., firm that specializes in pain medication, funded the event.