SEPTEMBER 1, 2018, Joint Base San Antonio – Pain Awareness Month in September allows medical professionals to increase awareness about the effects of pain and the treatment options available to alleviate pain.
According to the Department of the Army 2017 Health of the Force report, military musculoskeletal injuries result in over one million medical encounters and almost 10 million limited duty days each year for over 70 percent of the medically non-deployable population.
“Some musculoskeletal injuries result in persistent or chronic pain and this is an area where we want to intervene,” said Lt. Col. Sharon Rosser, Director, Army Comprehensive Pain Management Program, and Chair, Defense Health Agency (DHA) Pain Management Clinical Support Service.
“According to National Institute of Health (NIH), chronic pain affects more Americans than diabetes, heart disease, and cancer combined.”
The Army Comprehensive Pain Management Program plans to highlight healthcare provider and patient education relating to pain management and opioid safety during September.
“The Pain Awareness Month campaign is a key opportunity to raise awareness and provide education through social media messaging, educational brochures, information cards, posters, and digital messaging,” said Rosser.
At Defense Health Agency headquarters and some local military medical facilities pain awareness information tables will be set up during the month with experts available to answer questions and provide the educational products.
“Our [pain management] strategy focuses on effective treatment of acute and chronic pain while minimizing opioids and optimizing non-pharmacologic therapies,” said Rosser.
The program is designed to provide a comprehensive, holistic, multimodal, multidisciplinary, pain management plan utilizing state-of-the-art science and technologies to provide the best quality of life for patients with pain.
Army Medicine Pain Management is centered on the concept of the Military Health System Stepped Care Model for Pain that allows primary care teams to have pain champions, internal behavioral health consultants, and clinical pharmacists to assist in managing patients with pain that isn’t responding to initial treatment.
Patients that are not improving or responding to treatment in the primary and secondary levels of the Stepped Care Model, may receive additional care from one of the 12 Interdisciplinary Pain Management Centers that deliver therapies for patients with complex, chronic pain.
In 2017, the Interdisciplinary Pain Management Centers provided over 198,000 clinical visits for active duty service members and collaboration with sister services and the VA have resulted in a significant reduction in chronic opioid use to about four percent of active duty troops.
“Addressing the [national] opioid epidemic while continuing to treat pain effectively continues to be a priority, both from the patient perspective and from the perspective of medical readiness for combat,” said Rosser.
Army pharmacists are empowered to screen every opioid patient for risk of overdose, conduct an assessment, and provide naloxone and appropriate teaching if the patient has risk of respiratory depression.
Through interventional, rehabilitative, and integrative pain therapies the Army has reduced Opioid Use Disorder prevalence among the active duty Army to 0.15 percent in 2016 while the U.S. adult population rate is 0.90% according to CDC statistics.
Service members diagnosed with opioid use disorder have decreased by 38 percent between 2012 and 2016 (MHS Data Repository). Positive screening urinalysis from due to opioids has decreased across the Army since 2013.
“It is important to prevent misuse or addiction, and we have many initiatives in place to do just that, which is a key reason our addiction rates in active duty personnel are so low,” said Rosser.
Rosser explained that the interdisciplinary approach to pain management enables providers to be proactive and deliver the right care for the right patient within the right level of care.
Rosser recommends that if you are experiencing chronic pain to start with an open and honest conversation with your healthcare provider about what you are experiencing in order to find the right course of action. Your quality of life can be impacted by pain and having the right tools in place to address the impacts will make it easier to move towards wellness.
There are a number of activities individuals can use to self-manage pain but these activities need to be tailored based on the level of pain. Tai-chi, yoga, mindfulness, daily physical activity, engaging in social activities, and developing healthy eating and sleeping habits will all contribute to reaching your optimal level of health.
Interdisciplinary Pain Management Centers offer therapies often not included in civilian treatment plans such as yoga, acupuncture, medical massage, mindfulness therapy, occupational therapy, and chiropractor services.
“Many of our policies are specific to military medicine beneficiaries and show our commitment to maintaining the medical readiness necessary for an effective global force,” said Rosser.
Story by Wesley Elliott
U.S. Army Medical Command