The 2016 survey of the Life After Service Studies (LASS), revealed that Canadian Veterans are almost twice as likely to report chronic pain than the general Canadian population (41% vs 21%).

What is this Research About?

This study identified common characteristics of Veterans who had the highest rates of severe chronic pain; and discusses which Veterans require highly specialized services.

What did the Researchers Do?

The researchers conducted a two-step cluster analysis to characterize subgroups of Veterans with chronic pain using these five indicators: (1) pain intensity; (2) number of activities prevented by pain; (3) psychological distress; (4) PTSD symptoms; and (5) health-related activity limitations. Three Clusters of Veterans with chronic pain were identified based on similarities across these indicators.

What did the Researchers Find?

Veterans with chronic pain were slightly older, reported less household income and had greater prevalence of physical and mental health conditions than other Veterans.

They were also more likely to:

• Be dissatisfied with their finances (23% vs 14%)
• Be on disability (17% vs 2%)
• Have extreme life stress (7% v. 2%)
• Report suicidal ideation (13% vs. 5%)
• Experience a difficult adjustment to civilian life (47% vs 23%)

Cluster I (Lowest rates of severe pain) - Most Veterans with chronic pain were within this cluster (47%). Few reported severe pain (2%) or severe mental health problems (8%) and none had severe activity limitations.

Cluster II - 26% of Veterans with chronic pain were within this cluster. About a quarter of this group reported severe pain (27%) and severe mental health problems (22%). Almost all of the Veterans in this cluster reported severe activity limitation (91%). Cluster II individuals were more often women than the other two clusters.

Cluster III (Highest rates of severe pain) - 27% of Veterans with chronic pain were within this cluster. Veterans in this cluster were most likely to report severe pain (36%) and severe mental health problems (96%). The majority also reported severe activity limitations (72%). Compared to Veterans in the other two clusters, Cluster III individuals were more often middle-aged and single or never married. They were also more likely to report:

• lower education
• not working
• being on disability
• released at junior non-commissioned rank
• a difficult adjustment to civilian life

The proportions of Veterans with difficult adjustment to civilian life, suicidal ideation, low perceived social support and high service utilization increased incrementally from Cluster I to III.

The low rates of severe pain, mental health problems or activity limitations suggests that most Veterans in Cluster I could do well with typical health care supports.

However, the higher rates of physical health comorbidity, mental health problems, activity limitations, life stress and suicidal ideation reported by Veterans in clusters II and III, suggest that these Veterans are more likely to need highly specialized services and multidisciplinary care

Source

Reyes Vélez Julián , Thompson James M , Sweet Jill , Busse Jason W , VanTil, Linda . Cluster Analysis of Canadian Armed Forces Veterans Living with Chronic Pain – Life After Service Studies 2016. Canadian Journal of Pain. March 22, 2021

https://www.tandfonline.com/doi/full/10.1080/24740527.2021.1898278