Female military personnel and their families suffer from increased chronic pain, study finds

A new study led by researchers at Brigham and Women’s Hospital finds that military wives and female family members are at a significantly higher risk for chronic pain

Active-duty women who served during periods of intense combat deployment (2006-2013) are at significantly higher risk for chronic pain compared to women who served at other times, according to a new study from researchers at Brigham and Women’s Hospital, a founding member of the Mass General Brigham health care system.

The study also found that female family members of military personnel who served in 2006-2013 were more likely to experience chronic pain, and those with lower socioeconomic status and mental health conditions were at even higher risk. Results were published in JAMA Network Opened.

“Our goal was to examine the impact of frequent exposure to intense combat missions on military women and their civilian spouses,” said lead author Andrew Schoenfeld, MD, MSc, an orthopedic surgeon in the Department of Orthopaedic Surgery and the Center for Surgery and Public Health at BWH.

“My previous military service provided insight into the stress of repeated deployments on service members and their families. However, I was surprised by the magnitude of the effect we saw here, particularly among civilian female spouses. This underscores an overlooked aspect of deployment schedules that the military health system needs to recognize.”

Chronic pain, a stressful condition that lasts for months to years, can significantly reduce a person’s quality of life. According to the Centers for Disease Control and Prevention (CDC), as of 2021, 20.9% of American adults suffer from chronic painThis condition is also costly, both to individuals and to the healthcare system, due to the constant need for treatments and the immense losses in productivity.

Researchers conducted a cohort study using data from the Military Health System Data Repository, focusing on active duty women and female dependents of active duty members across all branches of the Department of Defense (Army, Air Force, Navy, and Marine Corps). The study included medical records of 3,473,401 individuals, ages 18 to 64, from 2006 to 2020.

Of these data, 324,499 individuals (9.3%) had a diagnosis of chronic pain. The study divided the cohort into two groups: one from 2006 to 2013, characterized by more intense combat exposure, and another from 2014 to 2020 with significantly less combat exposure. Individuals with pre-existing diagnoses of chronic pain before military service were excluded.

Comparing these cohorts, those who served between 2006 and 2013 had significantly higher rates of chronic pain (14.8% among active-duty military personnel and 11.3% among family members) compared to those who served between 2014 and 2020 (7.1% among active-duty military personnel and 3.7% among family members).

Specifically, female service members between 2006 and 2013 had a 53% higher chance of chronic pain than female service members between 2014 and 2020.

The study also found a link between chronic pain and factors such as mental health and socioeconomic status in people who served in the military or Marine Corps.

“People from disadvantaged economic backgrounds and those with pre-existing mental health conditions often face greater barriers to accessing medical and behavioral health care, which can exacerbate and prolong their suffering,” Schoenfeld said.

One limitation of these findings is that they are based on claims data. As a result, researchers were unable to directly interview patients to get a full picture of the circumstances and symptoms that led to their chronic pain diagnosis.

Moving forward, Schoenfeld and colleagues want to evaluate how persistent prescription opioid use differs between active-duty women and civilian dependents living with chronic pain. They also hope to conduct a prospective observational study to better understand the long-term health consequences of military deployment.