Women Veterans Health Care

Chronic Pain

As a woman Veteran, you understand the physical and emotional impacts of military service. You may even have lingering pain that interferes with your daily life.

You are not alone—millions of Americans live with some form of chronic pain, and many women Veterans accessing VA care experience chronic pain. Chronic pain is pain that lasts 6 months or more, long after the event or injury that caused it. Some people can have chronic pain even without prior injury.

Migraine and back pain are two of the top service-connected conditions for women Veterans. Many also experience chronic neck pain, pelvic pain, arthritis, joint problems, musculoskeletal pain, and fibromyalgia, among others. It's important to remember that chronic pain is not "in your head." Chronic pain is real pain that interferes with physical, social, and even emotional wellbeing. Chronic pain can:

• Make it difficult to work and perform everyday activities
• Make mental health conditions worse, like irritability, depression, anger, or even trauma
• Interfere with sleep
• Prompt people to withdraw from friends or loved ones
• Cause people to give up treasured activities like hobbies
• Make it hard to exercise, which can contribute to weight gain
• Create financial difficulties from lost wages or the high cost of medical treatments

Chronic pain conditions are complex, and treatments are not one-size-fits-all. However, it is possible to manage your pain and increase the quality of your life.

What services does VA provide for chronic pain?

Once pain is chronic, it is not likely that it will completely go away. Because of this, VA treatment strategies are focused on managing the pain and improving your quality of life by targeting the aspects of life that chronic pain affects (e.g. physical, social, emotional). For most people, the best pain care plans combine several different treatment strategies and can include:

• Physical Therapy: helps with movement and function of body parts. Techniques may include:
  • Heat treatments such as hot water baths, heating pads, and high-frequency sound waves to produce gentle heat deep in your tissues
  • Cold treatments such as ice packs, ice baths, and ice massage
  • Gentle stretching
  • Muscle strengthening
  • Vibration therapy
  • Aquatherapy (gentle physical therapy performed in a pool)
• Cognitive Behavioral Pain Self-Management (CBT-CP): These programs teach relaxation, pacing, healthy sleep habits, and encourage healthy movement. When used regularly, skills learned in these programs can help you do more with less pain.
• Acceptance & Commitment Therapy for Chronic Pain (ACT-CP): Chronic pain can make it hard to participate in activities like hobbies, exercise, work, caring for family, and volunteering. ACT-CP recognizes that this can have a big impact on your identity. It helps you to manage this distress and to engage with the things that are most important to you.
• Medications: Non-steroidal anti-inflammatory drugs (like ibuprofen), pain medications, and certain anti-seizure or anti-depressant medications can help relieve pain.
• Injections: Botulinum toxin and cortisone can be used to manage certain types of pain like headache, neck, and knee pain.
• Chiropractic care: Hands-on manipulation of the body to properly align the spine, relieve strain on muscles, and restore mobility to joints.
• Acupuncture: The placement of small needles into the skin at various points in the body to reduce pain, improve stress, and promote wellness.
• Yoga: Helps strengthen muscles, improves functioning, reduces stress, and improves mood.
• Mindfulness Meditation: It's common to have negative and distressing thoughts about the pain or how it impacts your life. Meditation techniques teach you to tune into your mind and body to increase awareness. It has been found to help reduce pain, improve mood, and decrease stress.
• Massage: Applying pressure to specific points on the body can help reduce stress and muscle tension which can alleviate some types of pain.
• Biofeedback: Bio refers to the body, and feedback refers to information fed back to you. In biofeedback, special sensors are used to detect bodily cues like muscle tension which is known to make pain worse. Once these sensors are applied, a clinician teaches you strategies (like deep breathing) to reduce the tension which can improve the pain.

Since mind and body are interconnected, activities to improve your mental health often can improve pain. The opposite is also true—treatments that help with physical pain and functioning can improve your mental health. In most cases, a balanced treatment plan that addresses physical and emotional wellbeing are necessary to optimize your pain care.

How do I access services for chronic pain at VA?

Talk to your VA health care provider to determine which approaches are best for you. When you talk with them, be prepared to share "how" pain interferes in your daily life. This will help you and your provider select the best treatments for you. Think about:

• What does pain keep you from doing? (e.g. exercising, working, playing with children or grandchildren)
• What would you like to be doing that you aren't doing now? (e.g. shopping for yourself, sleeping better, going for walks, participating in activities)
• What are you doing that you wish you weren't? (e.g. being sedentary, getting caught in a vicious cycle of overdoing things and paying the price)
• How does pain affect your mood? (e.g. makes you sad, irritable, anxious, depressed)

Not all therapies are available at all VA medical centers, and certain therapies may not be appropriate for all conditions. If a certain therapy is not available at your VA medical center, ask your provider or your Women Veterans Program Manager if similar care is available at a different facility in your community.

If you don't already use VA health care, you may want to use the following online tools:

Find out if you are eligible for VA health care

Enroll in VA health care if you haven't already

Find your local VA and make an appointment

Can I get disability compensation (monthly payments) from VA related to chronic pain?

You may be able to get disability benefits if your chronic pain was caused by—or got worse because of—your active military service. Explore disability eligibility here. If you have questions, a Veterans Benefits Administration (VBA) representative at your nearest regional office can explain more. Find your nearest regional office.

Where can I find more information, help, and resources on chronic pain?

• National Institute of Arthritis and Musculoskeletal and Skin Diseases, Information Clearinghouse, NIH*
• National Institute of Neurological Disorders and Stroke, NIH*
• American Chronic Pain Association†
• U.S. Pain Foundation†
• Learn About Proven Treatments for Chronic Pain
• Treatment Works For Vets ‐ proven mental health treatments for Veterans
• Pain Management and Opioid Safety

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The Women Veterans Call Center is your guide to women's health

If you have questions or can't find what you're looking for, you can call, text, or chat online with the Women Veterans Call Center (WVCC) at 855-829-6636 to get help and find available resources and services in your area. Trained women representatives can also:

• Provide you with information on enrolling in VA health care if you have not already
• Provide you with information on setting up a medical appointment in your area
• Provide you with information about your eligibility (including questions about disability ratings) and other VA benefits like employment, education, and home loans
• Connect you with your local VA Medical Center or local women's health contact who can assist in coordinating all the services you need

WVCC representatives are available Monday through Friday, 8:00 a.m. to 10:00 p.m. ET, and Saturday, 8:00 a.m. to 6:30 p.m. ET.

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