APPROACHES TO OVERCOME POST-TRAUMATIC PAIN SYNDROME IN VETERANS

V. I.  Letuk; I. K. Churpiy; Yu. S.  Kuravskaya; M. V.  Zelinska; M. V.  Mylenka; L. A.  Pylypuv

doi:10.64108/imh.2026.1.5.28

Автор(и)

V. I. Letuk Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0009-0003-5393-8238
I. K. Churpiy Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0000-0003-1735-9418
Yu. S. Kuravskaya Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0000-0002-1338-0757
M. V. Zelinska Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0009-0008-8623-4743
M. V. Mylenka Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0009-0002-0750-0246
L. A. Pylypuv Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine Автор https://orcid.org/0009-0000-2523-8670

DOI:

https://doi.org/10.64108/imh.2026.1.5.28

Ключові слова:

post-traumatic pain syndrome, chronic pain syndrome, mine-explosive trauma, physical exercises, neurotechnology, mirror therapy, physical therapy, veterans.

Анотація

Abstract. Post-traumatic pain syndrome in combat veterans in Ukraine is today one of the most acute problems of the healthcare system and national security. The specifics of modern combat operations, characterized by a high frequency of mine-explosive injuries and combined injuries, leads to the formation of complex pain conditions that often become chronic.

The modern strategy for overcoming post-traumatic pain in veterans is based on the principles of multimodality and personalization. The traditional biomedical model, which is focused mainly on pharmacological suppression of symptoms, is now actively supplemented by the biopsychosocial model. This approach considers pain as the result of the interaction of biological disorders, psychological states and social factors.

Purpose of the research. To conduct an analysis of the scientific literature and substantiate the effectiveness of modern approaches to correct post-traumatic pain syndrome in combat veterans.

Research results. The clinical picture of post-traumatic pain is characterized by significant polymorphism. Patients may complain of localized pain in the scar area, phantom sensations after amputations, as well as diffuse pain covering large areas of the body. A special place is occupied by the neuropathic component of pain, which manifests itself as burning, shooting or electric current sensations. Clinical manifestations are often aggravated by comorbid conditions, such as sleep disorders, depressive disorders and post-traumatic stress disorder, which creates a vicious circle of pain and psychological maladjustment.

The modern strategy for overcoming post-traumatic pain in veterans is based on the principles of multimodality and personalization. Pharmacological treatment remains an important basis, but it often has limited effectiveness in chronic conditions and carries the risk of side effects or addiction. Therefore, the global medical community is increasingly turning to non-invasive methods. Among them, interventional technologies, neurostimulation methods and psychological correction occupy a special place. An important trend is the use of virtual reality and biofeedback technologies, which allow influencing the higher centers of pain regulation in the brain.

Conclusions.

Theoretical analysis of the problem of post-traumatic pain syndrome in war veterans has shown that this condition is a complex neurophysiological phenomenon that goes beyond a simple reaction to tissue damage.
The modern paradigm of veteran rehabilitation is shifting from a purely biomedical model to a biopsychosocial one, where priority is given to multidisciplinary interaction and personalized programs. It has been established that the most promising approaches are those that integrate neuromodulatory technologies, virtual reality and cognitive-behavioral methods with traditional means of recovery.
Physical therapy plays a key role in the system of medical rehabilitation, acting as a connecting link between clinical treatment and social reintegration. It provides not only physical recovery and restoration of mobility, but also forms in veterans the skills of self-control over pain, which is a basic condition for their independence and high quality of life.
The scientifically substantiated effectiveness of physical therapy methods in chronic pain is based on the principles of neuroplasticity and activation of the body's internal reserves. It has been proven that the complex use of physical rehabilitation methods (therapeutic exercises, neurodynamics, mirror therapy) allows to significantly reduce the intensity of pain, improve the functional state and psycho-emotional stability of veterans.

Завантажити

Дані для завантаження поки недоступні.

Біографії авторів

V. I. Letuk, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine
I. K. Churpiy, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine
Yu. S. Kuravskaya, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine
M. V. Zelinska, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine
M. V. Mylenka, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine
L. A. Pylypuv, Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Ivano-Frankivsk National Medical University, Department of Physical Therapy and Occupational Therapy, Ivano-Frankivsk, Ukraine

Посилання

1. Iena, M., Rivelis, M. (2025) Osvita i nauka Ukrainy v umovakh viiny ta pisliavoiennyi period: materialy III Mizhnar. nauk.-prakt. konf. (Kyiv, 6–7 lystopada 2025 roku). Kyiv: Ekspres-obiava, S. 121.

2. Dzhyhun, L., Berehova, N., & Ihumnova, O. (2022). Sotsialna pidtrymka sotsialno-psykholohichnykh sluzhb viiskovozoboviazanoi molodi, formy roboty. Psychology Travelogs, (1), 117–133. https://doi.org/10.31891/pt-2022-1-8

3. Young, G., Thielen, H., Samuelson, K., & Jin, J. (2025). Neurobiology of chronic pain, posttraumatic stress disorder, and mild traumatic brain injury. Biology, 14(6), 662. https://doi.org/10.3390/biology14060662

4. Eliav, T., Benoliel, R., & Korczeniewska, O. A. (2024). Post-Traumatic trigeminal neuropathy: Neurobiology and pathophysiology. Biology, 13(3), 167. https://doi.org/10.3390/biology13030167

5. Kohut, O. (2023). Pervynna psykholohichna dopomoha poterpilym iz symptomamy hostroho stresovoho rozladu. Scientic Bulletin of Kherson State University. Series Psychological Sciences, (1), 31–38. https://doi.org/10.32999/ksu2312-3206/2023-1-4

6. Howard, I. [et al.]. (2025) Combat‐related peripheral nerve injuries. Muscle & Nerve. Vol. 71, No. 5. P. 768–781. https://doi.org/10.1002/mus.28235

7. Danylchenko, S. I., Tkachuk, A. V., Yesselbayeva, A. K., Golovchenko, I. V., Churpiy, I. K., Ryabushko, M. M., & Golovashchenko, R. V. (2026). The role of innovative physical rehabilitation tools in the recovery of amputee veterans. Clinical and Preventive Medicine, (1), 149–159. https://doi.org/10.31612/2616-4868.1.2026.18

8. Herman, P. M., Broten, N., Lavelle, T. A., Sorbero, M. E., & Coulter, I. D. (2019). Health care costs and opioid use associated with high-impact chronic spinal pain in the united states. Spine, 44(16), 1154–1161. https://doi.org/10.1097/brs.0000000000003033

9. Kruk, I. M., & Hryhus, I. M. (2023). Suchasnyi pohliad na psykholohichnu reabilitatsiiu viiskovosluzhbovtsiv z posttravmatychnym stresovym rozladom. Reabilitatsiini ta fizkulturno-rekreatsiini aspekty rozvytku liudyny (Rehabilitation & recreation), (15), 50–56. https://doi.org/10.32782/2522-1795.2023.15.6

10. Klymkiv, R. I., Kulmatytskyi, A. V., Bilobryn, M. S. (2025) Post-traumatic stress disorder in veterans: innovative therapy and prevention methods. Psykhiatriia, nevrolohiia ta medychna psykholohiia. Vyp. 12, № 1. S. 37–47.

11. Liu, Q., Qiu, P., Ma, T., Zhao, Y., Fu, S., Gao, M., Feng, Z., & Feng, L. (2025). Knowledge, mechanisms, and intervention of the polytrauma clinical triad in military pain medicine. The Korean Journal of Pain, 38(3), 222–243. https://doi.org/10.3344/kjp.24425

12. Wang, J. J., Bowden, K., Pang, G., & Cipta, A. (2013). Decrease in health care resource utilization with MILD. Pain Medicine, 14(5), 657–661. https://doi.org/10.1111/pme.12117

13. Esneault, B. S., Maddox, M. B., Loewe, E. M., Pappolla, M. A., Parker-Actlis, T. Q., Shekoohi, S., & Kaye, A. D. (2025). Pharmacologic and nonpharmacologic pain management in patients with traumatic brain injury: A multidisciplinary approach. Journal of Clinical Medicine, 14(24), 8713. https://doi.org/10.3390/jcm14248713

14. Prohrama vidnovlennia dlia viiskovykh — Kompleksna reabilitatsiia u Medicasano. Medicasano. URL: https://medicasano.com.ua/blog/prohrama-vidnovlennia-dlia-vijskovykh-shcho-vkliuchaie-i-iak-zapysatys/

15. Skúladóttir, H., Gunnarsdóttir, T. J., Halldórsdóttir, S., Sveinsdóttir, H., Holden, J. E., & Björnsdóttir, A. (2020). Breaking the vicious circle: Experiences of people in chronic pain on the pain rehabilitation journey. Nursing Open, 7(5), 1412–1423. https://doi.org/10.1002/nop2.512

16. Stones, C., Cole, F. (2014) Breaking the cycle: Extending the persistent pain cycle diagram using an affective pictorial metaphor. Health Communication. Vol. 29, No. 1. P. 32–40.

17. Karmazina, I.S., Bohdanovska, V.Yu. (2024) Rol humoralnoi lanky antynotsytseptyvnoi systemy u fiziolohichnomu kontroli bolovoi chutlyvosti. The Latest Technologies in Scientific Activity and the Educational Process. S. 305.

18. Siegmund G. P. [et al.]. Role of muscles in accidental injury. // Accidental Injury: Biomechanics and Prevention. New York: Springer, 2014. P. 611–642.

19. Shivangi Chaughule. (2025). Factors contributing to kinesiophobia in parkinson’s disease. Journal of Medical and Health Studies, 6(1), 35–47. https://doi.org/10.32996/jmhs.2024.6.1.4

20. Perrot, S. [et al.]. (2018) Kinesiophobia and physical therapy-related pain in musculoskeletal pain. Joint Bone Spine. Vol. 85, No. 1. P. 101–107.

21. Eapen, B.C., Murphy, D.P., Cifu, D.X. (2017) Neuroprosthetics in amputee and brain injury rehabilitation. Experimental Neurology. 2017. Vol. 287. P. 479–485.

https://doi.org/10.1016/j.expneurol.2016.12.009

22. Popel, S., Меlnic, I., Churpiy, І., Bejga, P., & Śliwiński, Z. (2022).

Condition of membranes of erythrocytes of peripheral blood of elderly people with chronic tiredness and low level of tolerance to physical load. Health, Sport, Rehabilitation, 8(2), 78–89. https://doi.org/10.34142/hsr.2022.08.02.07

23. Bubela, V.Yu. (2025) Derzhavni instrumenty nadannia medychnykh posluh viiskovosluzhbovtsiam: kvalifikatsiina robota mahistra. Vinnytsia: DonNU imeni Vasylia Stusa, 107 s. https://jqmth.donnu.edu.ua/article/view/19219/19116

24. Caddick, N., & Smith, B. (2014). The impact of sport and physical activity on the well-being of combat veterans: A systematic review. Psychology of Sport and Exercise, 15(1), 9–18. https://doi.org/10.1016/j.psychsport.2013.09.011

25. McGill, G., Wilson, G., Caddick, N., Forster, N., & Kiernan, M. D. (2020). Rehabilitation and transition in military veterans after limb-loss. Disability and Rehabilitation, 1–8. https://doi.org/10.1080/09638288.2020.1734875

26. Clark, M.E. [et al.]. (2007) Pain and combat injuries in soldiers returning from OEF and OIF. Journal of Rehabilitation Research & Development. Vol.44, No. 2.

27. Churpiy, I.K., Lapkovskyi, E.Y., & Yashchyshyn, Z.M. (2025). Effectiveness of rehabilitation and physical therapy program for post-stroke shoulder pain syndrome. Rehabilitation and Recreation, 19(1), 93–103. https://doi.org/10.32782/2522-1795.2025.19.1.9

28. Schnurr, P. P., & Lunney, C. A. (2018). Residual symptoms following prolonged exposure and present-centered therapy for PTSD in female veterans and soldiers. Depression and Anxiety, 36(2), 162–169. https://doi.org/10.1002/da.22871