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5 Articles in this Series
Simulation and Immersive Training Teaches Safe Opioid Prescribing to Pain Medicine Fellows & Anesthesiology Residents
Chronic Outpatient Opioid Use and Hospital-Acquired Infections
Individualized Pain Management Program Reduces Costs
Older Patients Benefit From Interdisciplinary Chronic Pain Rehabilitation
Interaction Between Chronic Pain Disorders and PTSD

Interaction Between Chronic Pain Disorders and PTSD

About 45% of service members who were depolyed during Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) experience chronic pain. Of combat veterans with chronic pain, approximately 60% will have co-morbid illnesses 1 year after deployment.1

Approximately 20% of veterans develop PTSD at some point during their lifetimes.In addition, almost 20% of members of the armed forces develop post-traumatic stress disorder (PTSD) at some point during their lifetimes.2 According to VA’s National Center for PTSD, the PTSD rate among Vietnam Veterans was 30.9% for men and 26.9% for women. For Gulf War Veterans, the PTSD rate was 12.1%. Operation Enduring Freedom/Operation Iraqi Freedom Veterans had a PTSD rate of 13.8%.3

To better understand the overlapping molecular and biological profiles associated with PTSD and specific chronic disorders, researchers examined blood samples from US veterans. They compared 2 data sets from Array-Express or Gene Omnibus Express. (E-GEOD-6378 and GSE47603). The first consisted of RNA and peripheral blood samples taken pre- and post-deployment from 24 US Marines who developed PTSD. The second sample was a comparison of blood from individuals with or without complex regional pain syndrome (n=2 CRPS I, n=2 CRPS II, and n= 5 control, GSE47603).4-6 “Analysis included pre-processing quality checks, normalization with robust multi-array average appropriate for the array type, post-processing quality check, annotation and differential expression analysis,” noted Emily Workman, PhD, who presented the study results.

“Our results demonstrate CRPS and PTSD co-regulate 60 different genes comprising 49 different GO-Terms. The predominant biological processes regulated by both PTSD and CRPS are catabolism, inflammation, and immune responses. These results indicate that there is substantial overlap between the 2 disorders,” she noted.



  1. McAndrew, L. M. et al. Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment. J Rehabil Res Dev. 2016;53:59-70.
  2. Lew, H. L. et al. Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: polytrauma clinical triad. J Rehabil Res Dev. 2009;46:697-702.
  3. VA Media Room. VA, DOD study a major breakthrough for understanding PTSD. March 24, 2017. Available at: https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2875. Accessed March 28, 2017.
  4. Breen, M. S. et al. Gene networks specific for innate immunity define post-traumatic stress disorder. Mol Psychiatry. 2015;20:1538-1545.
  5. Glatt, S. J. et al. Blood-based gene-expression predictors of PTSD risk and resilience among deployed marines: a pilot study. Am J Med Genet B Neuropsychiatr Genet. 2013;162B, 313-326.
  6. Jin, E. H. et al. Genome-wide expression profiling of complex regional painsyndrome. PLoS One. 2013;8, e79435.
  7. Workman E, Fowler M. Characterization of interaction between chronic pain disorders and Post-Traumatic Stress Disorder (PTSD). Poster presented at: Annual Meeting of the American Academy of Pain Medicine; March 16-19, 2017; Orlando, FL. Poster 184.
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