Severe Pain in Veterans: The Effect of Age and Sex, and Comparisons With the General Population

Abstract

This study provides national prevalence estimates of US military Veterans with severe pain, and compares Veterans to nonveterans of similar age and sex. Data used are from the 2010–2014 National Health Interview Survey (NHIS) on 67,696 adults who completed the Adult Functioning and Disability (AFD) Supplement. Participants with severe pain were identified using a validated pain severity coding system imbedded in the NHIS AFD. It was estimated that 65.5% of US military Veterans reported pain in the previous 3 months, with 9.1% classified as having severe pain. In comparison to Veterans, fewer nonveterans reported any pain (56.4%) or severe pain (6.4%). While Veterans aged 18–39 had significantly higher prevalence rates for severe pain (7.8%) than did similar-aged nonveterans (3.2%), Veterans age 70 or older were less likely to report severe pain (7.1%) than nonveterans (9.6%). Male Veterans (9.0%) were more likely to report severe pain than male nonveterans (4.7%); however, no statistically significant difference was seen between the two female groups. The prevalence of severe pain was significantly higher in Veterans with back pain (21.6%), jaw pain (37.5%), severe headaches or migraine (26.4%), and neck pain (27.7%) than in nonveterans with these conditions (respectively: 16.7%; 22.9%; 15.9%; and 21.4%). Although Veterans (43.6%) were more likely than nonveterans (31.5%) to have joint pain, no difference was seen in the prevalence of severe pain associated with this condition. Perspective Prevalence of severe pain, defined as that which occurs “most days” or “every day” and bothers the individual “a lot”, is strikingly more common in Veterans than in members of the general population, particularly in Veterans who served during recent conflicts. Additional assistance may be necessary to help Veterans cope with their pain.

Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey

“…The data are somewhat old; however, more recent studies of the OEF/OIF/OND population have reported similar characteristics. 2 The survey only inquired about a specific set of NPMs, and did not include questions about frequency or dose of medication or NPM treatment. Moreover, although questions were worded to inquire specifically about treatments used for pain, it is possible that some participants endorsed NPM use when that NPM was not pain-focused (e.g., attended psychotherapy that was not pain-focused), and it is not possible to examine details regarding NPMs (e.g., if therapy provided was an evidence-based intervention).…”

“…5 Veterans from this era have higher rates of pain than non-veterans of similar ages, than veterans from other eras, and than a representative sample of U.S. adults. 2,[5][6][7][8] Citing efforts to improve pain management and address the opioid crisis, the Department of Veterans Affairs and Department of Defense (VA/DoD) Clinical Practice Guideline, 9 Centers for Disease Control (CDC) Guideline for Prescribing Opioids for Chronic Pain, 10 , and National Pain Strategy (NPS) 11 have highlighted the importance of multimodal treatment for chronic pain including non-opioid pain medication and non-pharmacological modalities (NPMs). The recent VHA State-Of-The-Art (SOTA) Conference, BNon-pharmacological approaches to chronic musculoskeletal pain management,^identified a range of NPMs as having sufficient evidence of effectiveness to encourage their routine availability in VHA.…”

The Association Between Negative Trauma‐Related Cognitions and Pain‐Related Functional Status Among Veterans With Posttraumatic Stress Disorder and Alcohol Use Disorder

“…We did not specifically recruit for participants with CP; the average level of pain disability in our sample was mild to moderate, which was consistent with acute musculoskeletal pain condition samples but lower than CP samples (Anagnostis et al., ). Recent epidemiological studies estimate that up to 65% of U.S. veterans experience CP (Nahin, ); many veterans in our sample are likely to have or be at risk for CP conditions. Finally, this study included primarily male veterans with co‐occurring PTSD and AUD; thus, results may need to be carefully considered for populations outside of this particular subgroup.…”

Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort

“…; Toblin et al. ; Nahin ). Although recent national initiatives by the VHA have decreased the number of Veterans with opioid prescriptions, there remains concern that patients may be obtaining medications from alternative sources (Gellad et al.…”

“…This issue is particularly pertinent to the Veterans Health Administration (VHA) as it is the largest integrated health care system in the United States, and Veterans are at increased risk of experiencing chronic pain and developing opioid use disorders (Bohnert et al. ; Nahin ). Chronic pain impacts nearly half of Veterans and almost 25 percent of Veterans received opioid prescriptions as an outpatient in 2012 (Dorflinger et al.…”