Chronic pain following major trauma: Prevalence,predictive models,and risk factors across common injury types

Abstract

Introduction

Chronic pain is a frequent and disabling complication following major trauma. Despite its high prevalence, it remains under-recognised and inconsistently managed. To review current evidence on the prevalence, risk factors and predictive models for chronic pain following major trauma, with comparison between musculoskeletal trauma, thoracic trauma, and spinal cord injury.

Methods

This narrative review follows PRISMA 2020 guidelines. Studies published between 2015 and March 2025 were included if they examined adults with major trauma and chronic pain. Thematic synthesis was performed and stratified by trauma sub-type.

Results

Chronic pain occurs in 30–70% of trauma survivors, with prevalence varying by injury type. Key risk factors include female sex, younger age, pre-existing pain, psychological distress, and social disadvantage. Validated prediction models are available for musculoskeletal trauma, while preventive strategies remain inconsistently applied across trauma sub-types.

Conclusion

Chronic pain after major trauma is common. A trauma-informed, proactive approach is needed to improve outcomes.