Impact of the COVID-19 pandemic on Canadian Armed Forces Veterans who live with chronic pain

LAY SUMMARY Chronic pain is more frequent in military Veterans than in the general population. The objective of this study was to assess whether the COVID-19 pandemic has had a greater impact on Canadian Armed Forces (CAF) Veterans who live with chronic pain compared to non-Veterans. An online survey of Canadian adults with chronic pain was conducted between April and May 2020; 76 respondents reported having formerly served in the CAF and were compared with 76 similar non-Veterans. About two thirds of the Veterans had been living with chronic pain for longer than 10 years. Two thirds reported worsened pain since the pandemic began. Nearly half experienced moderate to severe psychological distress. These changes were similar to those in non-Veterans with chronic pain. A significant number of Veterans and non-Veterans changed their pain treatments due to the pandemic. In summary, the COVID-19 pandemic and associated restriction measures did not have a greater impact in CAF Veterans with chronic pain compared with non-Veterans. However, changes in chronic pain supports are needed to be better prepared for COVID-19 waves to come and future health crises. Introduction: Chronic pain is more prevalent in military Veterans than in the general population. The extent to which the COVID-19 pandemic has affected Canadian Armed Forces (CAF) Veterans living with chronic pain is unknown. This study compared the impact of the pandemic and public health measures on Canadian Veterans and non-Veterans. Methods: An online cross-sectional study was conducted across Canada. Participants (n = 3,159) were adults with chronic pain recruited from April to May 2020. Seventy-six participants reported having formerly served in the CAF and were pair-matched with non-Veterans. Results: CAF Veteran participants' mean age was 55.1 (standard deviation = 9.6) years; 50.0% were female. Over 60% lived with chronic pain for > 10 years. Two thirds of Veterans (67.1%) reported worsened pain since pandemic onset, and 44.7% experienced moderate to severe psychological distress. This was comparable to the non-Veteran group (63.2%, p = 0.61; 35.5%, p = 0.25), and no differences were found between female and male Veterans (p = 0.22, p = 0.36). Percentages of participants reporting changes in pharmacological pain treatments because of the pandemic were similar in CAF Veterans (14.9%) and non-Veterans (13.3%) (p = 0.68). Over 50% of Veterans modified their physical/psychological pain treatments due to the pandemic, compared with 45.3% of non-Veterans (p = 0.24). Discussion: Pain deterioration, psychological distress, and pain treatment changes were observed in CAF Veterans living with chronic pain during the COVID-19 pandemic, as was the case in non-Veterans. These results will help develop interventions to adequately face pandemic waves to come and future health crises.