American veterans experience higher prevalence of pain and more severe pain than nonveterans, with young and middle-aged veterans suffering the most, according to a new analysis of the National Health Interview Survey (NHIS) by the lead epidemiologist at the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health. This survey provides the first national estimate of severe pain associated with painful health conditions in veterans and nonveterans and underscores the importance of sustaining efforts to monitor and manage pain among veterans.
“Our analysis showed that veterans were about 40 percent more likely to experience severe pain than nonveterans,” said Richard L. Nahin, Ph.D., lead author of the analysis. “As well, younger veterans were substantially more likely to report suffering from severe pain than nonveterans, even after controlling for underlying demographic characteristics. These findings suggest that more attention should be paid to helping veterans manage the impact of severe pain and related disability on daily activities.”
The analysis is based on data from the 2010-2014 NHIS, in which 67,696 adults (6,647 veterans and 61,049 nonveterans) responded to questions about the persistence and intensity of self-reported pain during the three months prior to the survey. The majority of veteran participants were men (92.5 percent), while the majority of nonveteran participants were women (56.5 percent). The survey data did not identify any specific aspects of military service, including branch of the armed forces, years of service, or whether the veteran served in a combat role.
Among the findings from this analysis:
- More veterans (65.5 percent) than nonveterans (56.4 percent) reported having pain in the previous three months.
- A higher proportion of veterans (9.1 percent) reported having severe pain than nonveterans (6.3 percent).
- Younger veterans (7.8 percent) were substantially more likely to report suffering from severe pain than nonveterans (3.2 percent) of similar ages, even after controlling for underlying demographic characteristics.
- Veterans were more likely than nonveterans to have any back pain (32.8 percent), back pain with or without sciatica (12.2 percent, 20.5 percent), or joint pain (43.6 percent), but less likely to have jaw pain (3.6 percent) or migraines (10.0 percent).
- The prevalence of severe pain was significantly higher in veterans with back pain (21.6 percent), jaw pain (37.5 percent), severe headaches or migraine (26.4 percent), and neck pain (27.7 percent) than in nonveterans with these conditions.
- For nonveterans, as age increased, the prevalence of any pain and severe pain also increased; however, for veterans, those aged 50 to 59 were most likely to have severe pain, while the youngest and oldest groups were least likely to have severe pain.
- Veterans aged 18−39 and 50−59 were more likely than nonveterans of the same ages to have any pain. Veterans aged 18−39 were also more likely to have severe pain than nonveterans in the same age group. However, veterans aged 70 or older were less likely to have severe pain than similarly aged nonveterans.
- Male veterans (9.0 percent) were more likely to report severe pain than male nonveterans (4.7 percent); however, no significant difference was seen between the two female groups.
“These findings show that we still have much more to do to help our veterans who are suffering from pain,” said Josephine P. Briggs, M.D., director of NCCIH. “This new knowledge can help inform effective health care strategies for veterans of all ages. More research is needed to generate additional evidence-based options for veterans managing pain. Over time this research may help nonveterans as well.”
NCCIH is partnering with the Department of Veterans Affairs and Department of Defense on 13 grants to research military and veteran health with a focus on nonpharmacological approaches to pain and related conditions.
View downloadable graphics at nccih.nih.gov/veterans_pain.
About the National Center for Complementary and Integrative Health (NCCIH): NCCIH’s mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health approaches and their roles in improving health and health care. For additional information, call NCCIH’s Clearinghouse toll free at 1-888-644-6226. Follow us on Twitter (link is external), Facebook (link is external), and YouTube.
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Nahin RL. Severe pain in veterans: the impact of age and sex, and comparisons to the general population. Journal of Pain. November 21, 2016. pii: S1526-5900(16)30313-3. Epub ahead of print.