Chronic Pain in the Military

/ Thomas Cohn, MD

Army painA recent study published in JAMA Internal Medicine suggests that chronic pain in active and former military members is a significant problem.

The study surveyed 2,597 soldiers who served in either Iraq or Afghanistan in 2011 in order to understand how chronic pain affects their everyday lives. According to the survey results:

  • 45.4 percent reported suffering combat injuries.
  • 44 percent reported experiencing chronic pain.
  • 48.3 percent reported pain lasting at least a year.
  • 55.6 percent said they suffer from “constant” pain.
  • 51.2 percent said their pain was moderate to severe.

Those tasked with helping military members reintegrate back into society after a deployment know the management of physical and emotional pain is crucial. The study also attempted to uncover how military members use opioids to aid in pain management.

“I had conducted a similar study at [the] CDC because we felt that it was important to understand [the] use of opioids to get a greater context for misuse and abuse,” said lead author Dr. Robin L. Toblin, a clinical research psychologist at the Walter Reed Army Institute. “When I began my current position, we sought to look at the same constructs within a military population, who seemed to be that much more likely to be in pain due to the combat deployments over the last decade.”

Dr. Toblin noted that providing opioid therapy and management to combat veterans is key. Opioids can certainly ease pain after a combat injury, but problems can arise if veterans try to self-medicate or are uninformed about proper dosages. According to Dr. Toblin, 15.1 percent of soldiers say they have received opioid-based therapy to control their chronic pain.

“[Based on these findings], we hope that the military services will be more aware of the unmet needs for the assessment, management and treatment of pain and will broaden the services and availability of those services for servicemembers,” Dr. Toblin said.

The findings have touched off some debate over whether military members should be taking opioids. Obviously we want returning service members to be pain free, while others claim the drugs could affect their physical and mental performance. In the end, I think it really comes down to taking a strong, hands-on approach to ensure our veterans and returning servicemembers get the care they deserve and a treatment strategy that suits their individual situation.