Fighting Chronic Pain

More than three in four veterans we support live with chronic pain^.

We see the devastating impact pain can have. It derails careers. Strains relationships. And can seriously impact mental health. 

The rigorous physical nature of military life means service personnel sometimes get hurt. On average, four people are medically discharged from our Armed Forces every day.

The main reason being musculoskeletal injuries, which evidence shows increases the risk of chronic pain. 

But there’s good news. There’s lots that people with chronic pain can do to take back control of their lives. 

Our teams provide education and support to help make that happen. 

What is chronic pain? 

Chronic pain is any pain that’s lasted three months or more. The term has nothing to do with the severity. Pain that goes away within three months is called acute pain. 

Pain is useful and important. If we have a broken leg, touch a hot baking tray, or are having a heart attack, pain tells us something is wrong.  This type of pain should stop once the injury is healed. 

With chronic pain, the brain gets used to telling the body it’s in pain. It becomes overly protective and sends pain messages even though no damage is occurring to the body’s tissues.  

Pain stems from the brain, the body’s control centre. This is different from saying ‘it’s all in the mind’. The pain is real. 

The key is having a good understanding of pain, a healthy lifestyle, and finding the right balance between sensible activity and rest. 

Emotions and thoughts also stem from the brain. Upset or stress can fuel an overactive and confused pain messaging process. 

However, we can all retrain our brains to manage chronic pain better. 

Getting to the root of the problem 

Janine is one of our Veterans Clinical Advisors. She served in the Royal Navy for 25 years, and for most of that time worked as a nurse.  

“When someone comes to us in pain, we need to understand the whole picture,” she said.  

“If something medical is causing their pain, it needs to be treated within the NHS pathways and we can offer support and pain management advice alongside that. If there’s no obvious cause, we need to look beyond medical treatment and see what else can be impacting the pain, such as anxiety, sleep, nutrition, sensory inputs, inactivity. There are so many possible factors. 

“Many veterans are prescribed a range of strong medications for their symptoms, which should be monitored regularly for effectiveness, side effects or dependency.  

“It's about understanding your medications. Are you taking them at the right time to maintain a good quality of life? Are they the right medications for you? Are there side-effects and how are these impacting you?  

“Every aspect of someone’s life can affect, and be affected by pain, so we need to look at everything, including mindset.  

“In the military you’re conditioned to push through pain. If you injure your ankle in a war zone, you can’t sit it out, you need to carry on fighting or get out of danger.  

“When a child falls and is hurt, their parent will soothe and reassure them. When someone has chronic pain, they need to apply self-soothing behaviours.  

“Our free pain management course helps people understand what’s happening with pain and build a tool box of ways to reduce the pain.” 

Reducing stress 

Analysing what’s causing you stress, upset or worry, and trying to avoid or reduce those feelings are a big part of the puzzle.  

Janine continues: “If you work with a bully or you’ve got relationship worries, the emotional centre in your brain is affected. This sits alongside the part of the brain that sends danger signals out to the body. Stress can increase pain sensation.  

“If we’re on our phones 24/7, if we wake up and the first thing we do is check emails. Or we’re under financial pressure, the brain is always on high alert. The brain reads this as danger signals and can send out warning signals in the form of heightened pain sensations. We need to calm the system down.  

“Transition from the military is one of the worst causes of stress I see. Research shows it helps to look at when the chronic pain started. What was happening in someone’s life then? And try to work through any trauma, perhaps with therapy.”  

Our Hidden Wounds team supports veterans and families with a wide range of mental health conditions. 

We have a free mind, mood and body course to help you understand how emotions, thoughts and physical health are closely linked, and how to look after each of them. 

Getting active  

Loneliness and isolation are common among veterans. Add chronic pain into the mix and it becomes more problematic.  

“If you’re sitting indoors lonely and isolated, the stress and upset can set off warning messages, increasing that pain,” said Janine. “And if you’re spending all day focusing on the pain it becomes the biggest thing ever.  

“It helps to be active, as that produces endorphins, the body’s natural painkillers. When we say ‘exercise’ to a veteran, they might think of a marathon or a yomp with a Bergen on. But, for some, activity could be getting up and showered. Our Help for Heroes Cafes are a good activity to start with as it gets you out and talking, which is good for you physically and mentally.  

“Start off with something within your comfort zone, don’t overdo it, and gradually increase the amount you do. Stop before you’re having to fight through pain or fatigue. This can give you more energy for the next day or next week.  

“Pacing yourself is important. If you want to hoover the house, do one or two rooms a day, rather than the whole house at once.” 

Through our free sport and social activities, veterans and their families can be active, meet other people, and have fun.  

Fuel your body right 

Eating the right food plays a big role in pain management.  

Janine added: “Too much processed food can make your brain think there's an inflammatory response within the body and it will want to protect the body with pain messaging. 

“There’s a lot of research that shows how important good gut health is. Alcohol and smoking are bad for our gut health, as is some medication. 

“Staying at a healthy weight is important to reduce other chronic diseases and lower inflammation   which makes pain worse.”  

Our nutrition course explains the importance of having a healthy and balanced diet, and how to achieve that.  

The power of sleep 

Janine said: “Getting the right amount of good-quality sleep reduces stress and helps us manage pain. Our body repairs itself when we’re asleep. If we’re sleep deprived our brain is more likely to fire off pain messages.  

“Being in pain can make sleep more difficult. Our sleep course provides great advice on how to get a good night’s sleep.” 

Hope and understanding  

Janine added: “After a recent pain course a veteran said to me, ‘the biggest thing I’ve learnt is there's not one silver bullet that can fix this, apart from learning about pain and doing all those little bits that can make a big difference’.  

“And that’s the best answer. It’s not just about medication or what the doctors can or can’t do. It’s about empowering yourself by increasing your knowledge about chronic pain, nutrition, sleep, lifestyle, and self-soothing. And in some cases a reset from our military mindset of ‘pushing through’. 

“Pain can make people feel like they’re alone. But they’re not. We’re here for them. And there are many positive things people can do to feel better.”