Chronic Pain Management in Veteran Health Systems

Chronic pain affects a substantial proportion of veterans, reflecting both the physical sequelae of military service and the psychological burden of combat and training. Veteran health systems have evolved to address this challenge through integrated, multimodal approaches that combine pharmacological treatments with nonpharmacological and complementary therapies. Central to modern strategies is the concept of personalised care, whereby clinicians tailor interventions to individual patient profiles, incorporating factors such as comorbid mental health conditions, lifestyle, and social support. Pain management within veteran systems emphasises interdisciplinary collaboration among primary care providers, pain specialists, physiotherapists, psychologists and integrative health practitioners. The overarching aim is to reduce reliance on long-term opioid therapy, improve functional outcomes and enhance quality of life. Key innovations include whole-health models that prioritise patient empowerment and self-management, pragmatic trials embedded in routine clinical workflows, and digital tools for remote monitoring. As veteran populations age and policy landscapes shift, these systems continue to refine evidence-based pathways, balancing efficacy, safety and accessibility while responding to the global imperative of mitigating opioid misuse.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Chronic Pain Management in Veteran Health Systems publication trend

The graph below shows the total number of articles in chronic pain management in veteran health systems across all publications each year (not limited to Nature Index journals).

Technical terms

Chronic pain: Pain persisting beyond normal tissue healing time, often defined as lasting more than three months.

Nonpharmacological therapies: Interventions such as physiotherapy, cognitive behavioural therapy and exercise that do not rely on medications.

Complementary and integrative health (CIH): A spectrum of practices—including acupuncture and massage—that are used alongside conventional medical care.

Opioid stewardship: Coordinated strategies to optimise opioid prescribing, minimise misuse and monitor patient outcomes.

Pragmatic trial: A clinical study designed to evaluate the effectiveness of interventions in real-world clinical settings, prioritising external validity.

Whole-health model: An approach centred on patient empowerment, integrating personalised care planning, self-management and holistic therapies.

References

1. Research objectives and general considerations for pragmatic clinical trials of pain treatments: IMMPACT statement. Pain (2023).
2. Pain Management Strategies and Lessons from the Military: A Narrative Review. Pain Research and Management (2015).
3. Effectiveness of a whole health model of care emphasizing complementary and integrative health on reducing opioid use among patients with chronic pain. BMC Health Services Research (2022).
4. The use of complementary and integrative health approaches for chronic musculoskeletal pain in younger US Veterans: An economic evaluation. PLOS ONE (2019).
5. Whole Health Options and Pain Education (wHOPE): A Pragmatic Trial Comparing Whole Health Team vs Primary Care Group Education to Promote Nonpharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans—Rationale, Methods, and Implementation. Pain Medicine (2020).
6. Patient Experiences Navigating Chronic Pain Management in an Integrated Health Care System: A Qualitative Investigation of Women and Men. Pain Medicine (2018).