Return-to-duty rates among coalition forces treated in a forward-deployed pain treatment center: a prospective observational study

Anesthesiology. 2007 Dec;107(6):1003-8. doi: 10.1097/01.anes.0000290605.55736.e1.


Background: Non-battle-related injuries and the recurrence of chronic pain are major causes of medical evacuation in wartime. Because a pain medicine specialist may or may not be assigned to a forward-deployed medical unit, the treatment of pain from non-battle-related injuries in war zones is a serendipitous endeavor. Previous studies have demonstrated that the return-to-unit rate for soldiers evacuated to a tertiary care facility for pain management is abysmally low.

Methods: This is a prospective, observational study measuring return-to-duty rates in the first forward-deployed pain treatment center.

Results: Over a 6-month period, 132 patients were treated, the large majority (n = 113) of whom were coalition forces. In descending order, the four most common diagnoses among coalition forces were lumbar radiculopathy (n = 63), thoracic pain (n = 13), cervical radiculopathy (n = 8), and groin pain (n = 8). Epidural steroid injections (n = 125) were by far the most frequently performed procedure, followed by trigger point injections (n = 21), lumbar facet blocks (n = 16), and groin blocks (n = 9). Nonsteroidal antiinflammatory drugs were prescribed to 70% of patients, and 24% were referred to physical therapy. The return-to-duty rate for coalition forces was 94.7%. The primary complaint of all 7 patients who required medical evacuation outside the theaters of operation was groin pain.

Conclusions: These results demonstrate the feasibility of obtaining high return-to-duty rates when aggressive pain management strategies are used in forward-deployed areas.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Hospitals, Military / trends
  • Humans
  • Male
  • Middle Aged
  • Military Personnel*
  • Pain / epidemiology*
  • Pain Clinics* / trends
  • Pain Management*
  • Pain Measurement / methods
  • Pain Measurement / trends
  • Prospective Studies
  • Time Factors
  • Warfare*