Pain Management When you think of pain management you may think of treating a headache, rehabbing an injury or recovering from surgery. This shows that pain and pain management exist on a scale. Whether your pain is acute or chronic, there are a variety of options to help you manage it. How you choose to navigate pain is up to you and your care team – it also plays a role in staying mission ready. Identifying Your Pain Type Before finding an effective treatment plan, you must first identify the specific type of pain you’re experiencing. You’ve likely experienced varying types of pain such as sharp, dull, aching or burning, ranging from mild to severe intensity. What may be mild pain to you can very well be intense pain to someone else. Since every person is different, your treatment should match your specific needs. Pain is often placed into one of two categories: acute and chronic. Acute Pain Acute pain is usually sudden and typically results from an illness, injury or surgery. It often lasts for a short period of time – a few moments up to three months. It generally goes away once it’s treated. Chronic pain Chronic pain is continuous or recurring, lasting more than three months. It can persist long after healing from an illness, injury or surgery. Impact on Warfighters Musculoskeletal injuries (MSKIs) are the leading cause of limited duty days and medical non-deployment across all services. To maintain mission readiness, prevent injury through lifestyle behaviors, such as proper warm-ups and cool downs around exercise, eating nutrient-dense meals and getting adequate sleep. Engaging in these mindful and safe, or low-risk, behaviors supports injury prevention and recovery if you do get injured. Even if your injury, illness or surgery isn’t directly related to your service, the pain management protocol you and your care team come up with impacts your job. Whether you are in recovery and unable to perform your duties or ‘powering through,’ pain significantly limits your capabilities. In fact, it’s the number one cause of reduced readiness. If you experience acute pain, make sure to get the medical support you need in order to reduce further problems and prevent re-injury. If you experience chronic pain, talk to your care team as soon as possible to build a treatment plan that works for you and keeps you mission ready. Unique Warfighter Experience Your job may increase your risk for injury and overuse. Being aware of what physical and mental demands you are asking of your body, as well as how to properly prepare and recover, is essential to your health. Be mindful of how your work impacts you: Physical strain from equipment like heavy gear may cause spinal pain, muscle strain and joint damage Intense injuries from work-related physical activity typically result from jump landings, combat and training demands Spending long hours in restricted or repetitive positions such as sitting in a vehicle or plane, manning flight decks and working comms or drones Sleep interruptions and mental health challenges like shift work with irregular sleep-wake cycles, increased stress and severe fatigue Pain Management Techniques Most pain management techniques focus on treating chronic pain. Oftentimes, your care team will start out with a medication-based plan, then transition to non-medication techniques or a combination of both over time. If you experience chronic pain, you’ll likely use multiple techniques to effectively manage your pain. Medication: Whether you’re being treated for acute or chronic pain, your care team will likely recommend a form of medication. Though opioids are common pain relievers, the Military Health System has reduced these medications as a long-term pain management treatment due to their addictive properties. Your care team may recommend non-opioid medications. These options include topical or oral NSAIDs (e.g., ibuprofen), acetaminophen, antidepressants, anticonvulsants or medicated patches (e.g., lidocaine). Physical Therapy: If you experience an injury or have surgery that impacts your movements, you will likely work with a physical therapist (PT). They use a variety of techniques, such as manual massage and hydrotherapy. Your PT may also give you exercises to perform on your own between sessions. Acupuncture & Chiropractic Care: Alternative medicine techniques like acupuncture and chiropractic care are another option for pain management. Acupuncture is when very thin needles are inserted at different locations in your skin to disrupt pain signals. Chiropractic care manually adjusts your spine and joints to improve mobility and reduce pain. TRICARE covers both acupuncture and chiropractic care, though coverage is limited to certain pain conditions (e.g., lower back pain), requires prior authorization (PA) from your provider and often limited to specific Military Treatment Facility (MTF) locations. Injections & Nerve Blocks: If you have muscle spasms or nerve pain, there are certain injections and nerve blocks that help ‘short-circuit’ your pain. Depending on its severity, you may need to receive injections at certain time intervals like once every three months or once per year. Your care team will work with you to determine the best plan. High-Tech Methods: Your care team may recommend a variety of technological methods for pain management. Procedures using radio waves, electric signals and implants are all methods that target specific areas of your body experiencing pain. These are localized rather than ‘all over’ approaches, like medication. If a variety of methods aren’t as effective as you and your care team would like, surgery may be recommended. No matter your job, pain impacts your readiness and wellbeing. Whether it’s passing pain like a headache or cramp or persistent pain like a recovering injury or long-term back pain, it still affects you. If you feel something off, the best course of action is to see your care team as soon as possible. Taking care of pain early gets to the root problem and alleviates symptoms sooner. Depending on the cause of the pain, it could also save your military career. Additional ResourcesTRICARE - “Chiropractic Health Care Program”Defense & Veterans Center for Integrative Pain Management - “Uniformed Services University”ReferencesAmerican Society of Anesthesiologists - “Non-Opioid Treatment”Centers for Disease Control and Prevention - “Nonopioid Therapies for Pain Management”Cleveland Clinic - “Chronic Pain”Cleveland Clinic - “What’s the Difference Between Acute and Chronic Pain?”Garamone, J. - “Military Medicine Works on Managing Pain”TRICARE - “Learn How TRICARE Can Help You Manage Chronic Health Conditions”Vallerand, A. H. et al. - “Pain management strategies and lessons from the military: A narrative review”Westfall, R. L. - “Readiness through Pain Management”
