Pain, mental health, and health care utilization of military Veterans compared to civilians in a chronic pain clinic

LAY SUMMARY More than 40% of Canadian Veterans live with chronic pain. Chronic pain is often combined with mental health issues as well as the challenges of isolation and deconditioning. This study examined if there were differences in characteristics and type of care received between Veterans and civilians (people with no military service background) seeking care at a chronic pain clinic. The two groups of individuals with chronic pain were quite similar in pain outcomes, physical function, and mental health. Veterans visited chiropractors, massage therapists, physiotherapists, and psychologists more often than civilians. Although Veterans received this extra care and support, they were almost three times more likely to have thoughts of suicide. It was concluded that Veterans with chronic pain would greatly benefit in participating in an interdisciplinary pain care program tailored to Veteran-specific needs. Introduction: The purpose of this study was to identify differences in the biopsychosocial characteristics and health care utilization between Veterans and adult civilians with chronic pain seeking care at an interprofessional chronic pain clinic. Methods: Patient-reported data was extracted from the Kingston Health Sciences Centre Chronic Pain Registry between November 2017 and October 2019 (N = 1,090). Veterans were identified (n = 47) and age/sex-matched with randomly selected adult civilians (n = 94). Descriptive and comparative statistics were assessed for socio-demographics, biopsychosocial measures (pain severity, pain catastrophizing, fear of movement, suicidal ideation, depression, quality of life), and health care utilization in the year preceding enrollment into an interprofessional chronic pain clinic. Results: Veterans were predominantly male with a mean age of 57 +/- 14 and reported more suicidal ideation compared to age/sex matched civilians (23% vs. 8.6%). There were no differences in the biopsychosocial measures found between groups. Veterans reported seeking more community chiropractor, massage therapist, physiotherapist, and psychologist care as compared to civilians. Discussion : This descriptive study included Veteran and civilian populations matched by age and sex to gain a better understanding of any differences in chronic pain presentations between these two populations at the time of admission to a chronic pain clinic. Although Veterans reported a heavier utilization of community-based health care, this population presents similar biopsychosocial characteristics, but higher suicidal ideation, than the civilian population. Findings highlight the importance for chronic pain clinics to offer tailored pain management programs for Veterans.