Because the study examined only cases with a primary diagnosis of headache, it probably understates the disorder’s true impact, Dr. Cohen said. Posttraumatic stress disorder, musculoskeletal injuries, concussions, and motor vehicle accidents – all very common wartime injuries – can cause chronic headaches.
Whether soldiers return to the battlefield, or are kept on active duty and treated outside the war theater, the cost to the military is high, he said. "We now know that two-thirds of those who leave with headache don’t come back, and even if they do, they may have limitations. They might not be able to go on foot patrol or wear their Kevlar gear – but they are still using resources. And for every soldier who is evacuated, the unit goes short and someone else has to be deployed."
Headache treatment can last for months, he added, tying up military medical centers during active duty and after discharge.
"They continue utilizing medical and military resources the whole time they are being treated, and this costs America a huge amount of money," he said. "Even if all our troops would pull out tomorrow, we will be paying for this for the rest of our lives, as will the soldiers who are injured."
The study was funded by a grant from the John P. Murtha Neuroscience and Pain Institute, the U.S. Army, and the Army Regional Anesthesia and Pain Medicine Initiative. Dr. Cohen had no financial declarations.