By Cara Michelle Mitchell
At 45, retired Army Captain Marissa Mitchell winces whenever she gets off the couch or out of her car. “I walk like a little old woman,” she said with worry in her voice. It’s a stark contrast to the strong soldier who once traversed Baghdad’s rough terrain.
But years of oversized body armor, long marches, and the persistent stress of warfare have exacted a steep price. “My doctor said, ‘You’ve got the spine of a 75-year-old woman, the muscle volume of a college athlete,’” she told The Epoch Times.
Capt. Mitchell’s story of chronic pain isn’t unique; it’s a window into a problem affecting women who have served in the military at hostile times. Similarly, female family members of military personnel are also disproportionately affected by chronic pain.
How Service Era and Rank Shape Risk of Chronic Pain
Chronic pain, which can persist for months or years, significantly diminishes quality of life.
A recent study of more than 3.4 million active-duty servicewomen and dependents, with an average age of around 29, illuminates the challenges faced by servicewomen.
About 18.6 percent were active-duty servicewomen, and 9.3 percent were diagnosed with chronic pain. Women with preexisting chronic pain diagnoses before military service were excluded from the analysis.
The findings, published in JAMA Network Open, suggest a 53 percent higher risk of chronic pain for women deployed during periods of intense combat compared to less volatile times.
Women who served in the military between 2006 and 2013 were about 1.5 times more likely to have chronic pain than those who served from 2014 to 2020.
Family members of service personnel in the earlier period were nearly twice as likely to have chronic pain compared to those in the later period.
Lower-ranking enlisted servicewomen from 2006–2013 were about twice as likely to have chronic pain compared to higher-ranking officers.
The study also showed several factors influence chronic pain development, highlighting disparities among military branches and other variables.
Army and Marine Corps members, particularly those in junior enlisted ranks, reported higher rates of chronic pain compared to Air Force personnel. This difference likely reflects variations in mission types across branches.
The study also found that lower-income junior enlisted personnel were more likely to develop chronic pain.
Challenges faced by low-income individuals and those with preexisting mental health issues in accessing medical and behavioral health care exacerbate suffering, Dr. Andrew Schoenfeld, an orthopedic surgeon at Brigham and Women’s Hospital and lead study author, said in a press release. He echoed a previous study that found that people with mental health conditions have an over 60 percent higher likelihood of chronic pain, attributed to the stress and trauma associated with military service.
The JAMA Network Open study also found a significant increase in chronic pain associated with the polytrauma clinical triad among military members between 2006 and 2013. This triad consists of three common health issues: head trauma from blast injuries, psychological conditions, such as post-traumatic stress disorder (PTSD), and various pain disorders, including musculoskeletal and nerve pain.
During this period, individuals with chronic pain were seven times more likely to experience this combination of conditions than those serving between 2014 and 2020.
Chronic Pain Among Military Spouses
The study also sheds light on the plight of military families.
“I was surprised by the magnitude of the effect we observed here, particularly among female civilian spouses,” Dr. Schoenfeld noted in the press release. “This underscores an overlooked aspect of deployment schedules that the Military Health System must recognize.” The study elaborated on stressors such as the following:
- Fear for the deployed spouse’s safety
- Assuming single-parent duties
- Income changes
- Disruption in social support
Future Research Plans
Chronic pain strains both individuals and health care systems, requiring ongoing treatment and affecting productivity, according to the researchers. They acknowledged several limitations in their study.
For instance, their reliance on claims-based data may have introduced inaccuracies due to potential coding errors. The methodology may have led to an underestimation of chronic pain prevalence. This is because the study didn’t account for cases diagnosed after military service or during care provided by the Department of Veterans Affairs.
The study authors stated in the press release that their future research plans include examining how chronic pain affects prescription opioid use among military women, who, according to some evidence, receive opioid prescriptions at higher rates than men. They also plan to investigate the long-term health effects of military service, including its impact on overall health and quality of life.
Capt. Mitchell has access to a range of treatments for her chronic pain, including physical therapy, acupuncture, medication, and psychotherapy. Yet finding effective relief remains an uphill battle.
Despite exhausting various therapies and even undergoing a full fasciotomy, a surgical procedure to reduce muscle pressure by cutting the surrounding tissue (fascia), in 2013, she continues to grapple with persistent orthopedic pain in her knees, hips, and back.
She worries about her future mobility. “I’m afraid of what it’s going to look like in 10 years,” she said.
