Pain in Veterans is More Prevalent and Severe Than in Non-Veterans

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It may be that some veterans would benefit from a revised pain management plan with an emphasis on patient-centered care.
It may be that some veterans would benefit from a revised pain management plan with an emphasis on patient-centered care.

An analysis of data from the National Health Interview Survey (NHIS) showed that veterans of the armed forces had a greater severity and prevalence of pain than their non-veteran counterparts. The analysis, conducted by Richard L. Nahin, PhD, was published in Journal of Pain ahead of print in November 2016.1

According to Dr Nahan, lead epidemiologist at the National Center for Complementary and Integrative Health (NCCIH), the study was suggested by the 2011 Institute of Medicine report on pain in which veterans were identified as an at-risk population.  “Part of this high-risk status results from the increasing advances in medical care, especially injury-related trauma, that have resulted in many veterans surviving severe injuries that would have previously been fatal,” Dr Nahan told Clinical Pain Advisor.

For the study, Dr Nahan analyzed responses from the 67 696 adults (6647 veterans and 61 049 nonveterans) who completed the Adult Functioning and Disability (AFD) Supplement of the NHIS from 2010-2014.

Results from the study showed that a higher proportion of veterans (65.5%) reported pain in the last 3 months than non-veterans (56.4%), with 9.1% of veterans vs 6.3% of non-veterans reporting severe pain for that time period. Veterans aged 18-39 were more than twice as likely to report severe pain than similar-aged nonveterans (7.8% and 3.2% respectively).

However, severe pain was less prevalent in veterans aged 70 or older (7.1%) than in non-veterans (9.6%). The prevalence of severe pain was much greater in male veterans (9.0 percent) than male nonveterans (4.7 percent); however, female veterans and female nonveterans reported similar levels of severe pain.

Additionally, veterans were more likely than non-veterans to be affected by painful conditions such as back pain, jaw pain, severe headaches, and neck pain, and were also more likely to report severe pain associated with these conditions. 

Summary & Clinical Applicability

Dr Nahan noted that the evidence of increased pain among veterans suggests that more attention should be paid to pain management strategies in this population.

“It may be that some veterans would benefit from a revised pain management plan with an emphasis on patient-centered care,” he said. “This revised plan will sometimes require multimodal pain management that could cover a wide range of different types of therapies including behavioral, pharmacological, surgical, psychological, and complementary approaches as needed.  For others, additional services may be needed to help manage the impact of severe pain and related disability on daily activities.”

Limitations & Disclosures

The study was performed as part of the author's official federal duties. No outside financial support was provided. The author has no competing interests.

Reference

Nahin RL. Severe Pain in Veterans: The Impact of Age and Sex, and Comparisons to the General Population. J Pain Off J Am Pain Soc. November 2016. doi:10.1016/j.jpain.2016.10.021.

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