Military Veterans experience chronic pain at a higher rate than other people in Canada

About 41% of Veterans live with chronic pain, nearly double the rate of the civilian population, and 63% of Veterans with chronic pain live with a mental health condition.1,2

Veterans have developed their identities within a military culture

Military culture encourages collectivistic and “missionbefore-self” mindsets,3 which can affect Veterans’ experiences of pain. Being mission focused and disciplined may help Veterans follow treatment plans and clinical guidance.4 However, Veterans with severe pain may push past their pain to complete tasks that support their team or family. Veterans may benefit from learning pacing skills to know when to stop, take a break, or modify their activities.

Veterans face barriers to care and may distrust health care institutions

In transitioning from federally funded and delivered care to provincial or territorial systems, Veterans commonly report challenges with finding a family physician and transferring medical information.5 Some Veterans may distrust government institutions if they experienced moral injury, systemic discrimination, or violence during service.5 Veterans may have reservations about disclosing health issues owing to fear that doing so will affect their eligibility for benefits with Veterans Affairs Canada.5 Physicians should be transparent about delays (e.g., how long it will take to see a specialist or schedule a surgery) to promote trust.4

Aspects of military service can make it more difficult for Veterans with chronic pain and mental illness to cope

Challenges include stigma regarding seeking help, associating pain with weakness, or concerns about not “pulling their weight.” Using a communication tool,4 clinicians should inquire whether these factors resonate with patients as they can affect care trajectories and treatment success.

Refer to a Veteran’s time in the military as “service”

If clinicians have questions about a patient’s time in the military, they should avoid using the words “employment” or “work” and instead ask them about their service (e.g., “When you were serving …”).4 Clinicians can learn about Veterans’ experiences in a supportive and nonjudgmental manner and communicate that they are there to serve them.

Footnotes

Competing interests: Kayla May is a knowledge mobilization specialist with the Chronic Pain Centre of Excellence for Canadian Veterans, where Abhimanyu Sud serves as chief scientific officer. No other competing interests were declared.

This article has been peer reviewed.

Editor’s note: Duncan Redburn has lived experience as a Veteran of the Canadian Armed Forces. Content in this article was, in part, informed by learnings from a Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE) webinar presentation by a Veteran3 as well as lived experience insights shared by Veterans during group discussion at a stakeholders’ conference hosted by the CPCoE.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/

References↵↵↵↵↵

Best Advice guide: Resources and considerations in providing care to Veterans, 2nd edition. Mississauga (ON): College of Family Physicians of Canada; :1–37.