Chronic pain can be a silent burden. For many women who serve or have served in the military, it’s an all-too-familiar companion. Military women face unique challenges. Intense training, deployment stress, and exposure to combat.
All take a toll on the body and mind. And it’s not just the physical injuries. Emotional and mental strains add to the picture, creating a perfect storm for developing long-term pain conditions.
What Is Chronic Pain, and Why Is It a Concern for Military Women?
Chronic pain is any pain that persists for 12 weeks or longer, often beyond the usual healing period. It differs from acute pain, a direct response to injury or illness. Chronic pain can continue even after the underlying cause has resolved.
For many, it becomes a persistent condition, affecting physical, emotional, and mental well-being. It often requires ongoing management rather than a straightforward cure. Its prevalence is widespread. An estimated 20% of adults in the United States have it.
Military Women at Risk
Military service may have physical and psychological stressors. Women in the military often face similar demands as their male counterparts, from rigorous physical training to deployment and combat exposure.
However, they face unique physiological and social stressors that can worsen chronic pain. Hormonal fluctuations and a higher incidence of musculoskeletal injuries are common factors. Additionally, balancing military duties with family or caregiving responsibilities adds to their challenges. Conditions like fibromyalgia, pelvic pain, and migraine are also more common among women.
Why Chronic Pain Is a Growing Concern
Surprisingly, military women are twice as likely to experience musculoskeletal injuries as men. These injuries often occur during training or while deployed and can lead to the development of chronic pain if not managed effectively. Studies indicate that up to 70% of women veterans report experiencing chronic pain.
The rate is significantly higher than in the general female population. These statistics underline an important concern. Chronic pain not only impairs quality of life but also affects military readiness and the ability to perform essential duties.
Furthermore, many military women may delay seeking treatment. This can be due to stigma, career concerns, or a culture that promotes endurance over vulnerability. This delay can worsen the condition. The reluctance to seek care can also be due to limited access to healthcare. This is especially true for those deployed or in remote locations.
Comorbidities: The Mental Health Connection
Chronic pain rarely occurs alone, and in female service members, it often coincides with mental health challenges. Military women who report chronic pain also experience anxiety, depression, or PTSD.
This cycle of pain and mental health struggles is well-documented: pain can worsen psychological distress, and in turn, mental health issues amplify the perception of pain.
Military Sexual Trauma (MST) and Chronic Pain
Military Sexual Trauma (MST) is reported by nearly 1 in 3 women veterans, and it significantly increases the risk of chronic pain. MST encompasses both sexual assault and threatening sexual harassment during service.
And research indicates that women who have experienced MST are more likely to develop conditions such as fibromyalgia, musculoskeletal pain, and headaches.
Impact on Quality of Life and Duty
Chronic pain touches every aspect of life. For military women, it can impair work performance, reduce focus, and disrupt sleep, often making it difficult to meet service demands.
In severe cases, chronic pain may lead to reassignment to non-combat roles or even early medical discharge. Beyond duty, pain affects the quality of life, limiting social interactions, reducing the ability to engage in physical activities, and straining personal relationships. The physical discomfort and psychological stressors can lead to increased feelings of isolation and diminished emotional well-being.
What Are the Study’s Key Findings on Chronic Pain in Military Women?
A recent study examined the development of chronic pain conditions in military-affiliated women, including active-duty servicewomen and civilian dependents. It focused on two key periods: 2006-2013, a time marked by intense combat and deployment, and 2014-2020, when combat intensity decreased. The findings revealed significant differences in the diagnosis of chronic pain between these periods.
Significant Differences in Chronic Pain Diagnoses
The study analyzed data from the Military Health System repository, covering over 3.4 million women (median age: 29). Among them, 644,478 (18.6%) were ADSW. The rest were civilian dependents. Chronic pain diagnoses were significantly more prevalent in both groups during 2006-2013 compared to 2014-2020.
- Among ADSW: Chronic pain was diagnosed in 14.8% of those serving between 2006-2013. In contrast, only 7.1% of ADSW serving between 2014-2020 were diagnosed with chronic pain.
- Among Civilian Dependents: 11.3% of dependents in the earlier period were diagnosed with chronic pain, while this rate dropped to 3.7% in the latter period.
The statistics reveal that the incidence of chronic pain was nearly cut in half between the two periods. This suggests a strong link between times of intense combat exposure and the rise in chronic pain rates. The impact appears to be particularly significant among women affiliated with the military.
Odds Ratios Highlight Increased Risk During 2006-2013
The study utilized odds ratios (ORs) to compare the likelihood of chronic pain diagnoses between the two periods, taking into account various confounding factors. The results confirmed a significantly higher risk of chronic pain among both ADSW and dependents during the period of intense combat:
- ADSW: The odds of developing chronic pain were 1.53 times higher during 2006-2013 than in 2014-2020 (95% CI, 1.48-1.58).
- Civilian Dependents: The odds of chronic pain were even higher among dependents. With a 1.96 times increased likelihood in the earlier period (95% CI, 1.93-1.99).
The elevated odds ratios from 2006 to 2013 highlight how the physical and psychological demands of combat exposure impacted military women. When combined with deployment-related stressors, these factors may have contributed to an increased risk of developing chronic pain.
Role of Socioeconomic Status in Chronic Pain Risk
The study also explored how socioeconomic status affected the incidence of chronic pain, using military rank as a proxy indicator. Lower-ranking military personnel, often referred to as “junior enlisted,” showed significantly higher odds of chronic pain:
- Junior Enlisted ADSW (2006-2013): 1.95 times more likely to develop chronic pain compared to their counterparts in 2014-2020 (95% CI, 1.83-2.09).
- Junior Enlisted Dependents (2006-2013): A startling 3.05 times more likely to be diagnosed with chronic pain compared to similar individuals in the later period (95% CI, 2.87-3.25).
Socioeconomic challenges, such as limited access to healthcare, financial instability, and the stress of lower military ranks, may increase the risk of chronic pain. These findings highlight the need for additional support for lower-ranking military members. Providing resources is particularly crucial for families during times of heightened deployment. Addressing these issues can help reduce the burden of chronic pain among those serving.
Association Between Combat Exposure and Chronic Pain
This study highlights a strong connection between combat exposure and chronic pain. From 2006 to 2013, a period of intense combat and deployments, there was a rise in stress, injuries, and trauma among ADSWs and their families.
This timeframe correlates with a surge in chronic pain diagnoses within these groups. The findings support the theory that chronic pain is closely linked to the stressors and physical challenges faced in combat service. The relationship between deployment intensity and long-term health outcomes is clear.
For civilian dependents, the effects of deployment can extend beyond the direct experience. Indirect factors like stress, anxiety, and family disruptions may contribute to chronic pain.
Such stressors not only impact mental well-being but can also manifest physically. This combination of emotional and physical challenges often leads to conditions that cause or worsen chronic pain.
Importance of Mental Health Factors
While the study primarily focused on the physical manifestation of chronic pain, it also acknowledges the potential role of mental health factors. For example, exposure to military sexual trauma (MST), stress regulation difficulties, and inadequate coping strategies were suggested as potential contributors to the heightened incidence of chronic pain among women during 2006-2013.
Servicewomen are at risk for MST, which may increase the likelihood of developing chronic pain. This trauma, combined with the demands of military life, could heighten stress and contribute to conditions like fibromyalgia, migraines, and musculoskeletal disorders. All common sources of chronic pain among women.
Implications for Military Healthcare and Policy
The findings of this study have broad implications for the care and support of military women. First, it underscores the need for proactive healthcare measures during periods of heightened combat. Early interventions, mental health support, and comprehensive pain management could help reduce the risk of chronic pain development.
For those already diagnosed with chronic pain, specialized treatment is necessary. This includes considering the unique needs of military women, both ADSW and dependents, and providing access to a range of treatments — from physical therapy to mental health counseling — to address the multifaceted nature of chronic pain.
Additionally, recognizing the impact of socioeconomic status is vital. Providing additional support for lower-ranking service members and their families, especially during intense deployment periods, can improve health outcomes and reduce the burden of chronic pain.
What Are Potential Strategies for Preventing and Managing Chronic Pain in Military Women?
Preventing and managing chronic pain in military women requires a multifaceted approach. Because of their unique challenges — intense physical demands, deployment stress, and higher risk for conditions like military sexual trauma (MST) — strategies need to address both physical and mental health aspects.
Early Intervention
Early assessment and treatment of injuries can reduce the risk of pain becoming chronic. Physical therapy, rest, and tailored exercise programs help prevent musculoskeletal pain. For those already experiencing acute pain, prompt care can prevent the progression of chronic conditions.
Mental Health Support
Stress, anxiety, and PTSD can exacerbate chronic pain. Providing mental health resources, such as counseling and stress-management programs, is vital. Cognitive-behavioral therapy (CBT) can help servicewomen develop coping strategies, potentially reducing pain intensity and improving quality of life.
Physical Activity and Rehabilitation
Regular, low-impact physical activity — like yoga, swimming, or walking — can maintain mobility and reduce pain. Rehabilitation programs focusing on strength, flexibility, and posture may alleviate symptoms of chronic musculoskeletal conditions common among military women.
Education and Awareness
Educating servicewomen on the risks of chronic pain, self-care practices, and the importance of seeking medical help promptly. Empowering them with knowledge helps combat stigma around pain and mental health issues, encouraging earlier interventions.
Comprehensive Pain Management Plans
A multidisciplinary approach involving doctors, physical therapists, psychologists, and pain specialists. Combining medication, physical therapy, mental health support, and lifestyle changes to address chronic pain holistically.
How can the TMS Institute of Arizona Help Servicewomen with Chronic Pain?
TMS Institute of Arizona offers Transcranial Magnetic Stimulation (TMS), a noninvasive and medication-free way to manage chronic pain. TMS uses a “top-down” approach by targeting the brain to adjust how it processes pain signals. This helps reduce pain that’s too strong or has lasted longer than needed without the side effects of medication.
TMS leads to a significant reduction in pain for about half of our patients — by 33% or more. Most start feeling relief within a few days, and the effects can last for months. To help maintain this relief, we also provide regular maintenance sessions.
TMS therapy is particularly effective for those dealing with chronic pain linked to mental health issues, like depression or PTSD, which are common for military women. Our personalized care ensures the treatment fits each person’s unique needs, making getting back to a better quality of life easier.
Contact us at the TMS Institute of Arizona to see how TMS can help you find relief.
References
Cichowski, S. B., Rogers, R. G., Clark, E. A., Murata, E., Murata, A., & Murata, G. (2017). Military Sexual Trauma in Female Veterans is Associated With Chronic Pain Conditions. Military Medicine, 182(9), e1895–e1899. https://doi.org/10.7205/milmed-d-16-00393
What is MST? Military Sexual Trauma. (2024, October). DAV. https://www.dav.org/get-help-now/veteran-topics-resources/military-sexual-trauma-mst/
Peppard, S. W., Burkard, J., Georges, J., & Dye, J. (2022). The Lived Experience of Military Women With Chronic Pain: A Phenomenological Study. Military Medicine, 188(5-6), 1199–1206. https://doi.org/10.1093/milmed/usac134
- (2014). VA.gov | Veterans Affairs. Va.gov. https://www.womenshealth.va.gov/topics/chronic-pain.asp
- Jason Yong, Mullins, P. M., & Bhattacharyya, N. (2021). Prevalence of chronic pain among adults in the United States. Pain, 163(2), e328–e332. https://doi.org/10.1097/j.pain.0000000000002291
Schoenfeld, A. J., Cirillo, M. N., Gong, J., Bryan, M. R., Banaag, A., Weissman, J. S., & Koehlmoos, T. P. (2024). Development of Chronic Pain Conditions Among Women in the Military Health System. JAMA Network Open, 7(7), e2420393–e2420393. https://doi.org/10.1001/jamanetworkopen.2024.20393
Important: The findings from the study in this article are intended to inform and educate. They do not serve as a substitute for personalized medical advice. Consult a healthcare provider for specific medical needs.
