According to the National Institutes of Health, U.S. veterans experience higher rates of chronic pain compared to nonveterans (65.6% vs. 56.4%), and one in ten (9.1%) veterans live with severe chronic pain. Unlike acute pain, which is typically brief, chronic pain lasts for three months or longer. The U.S. Department of Veteran Affairs (VA) lists the most common forms of chronic pain among Iraq and Afghanistan veterans as being joint pain, back pain and other musculoskeletal pain. These may be caused by injuries sustained during military service or from health problems such as arthritis, shingles or diabetes. Other factors such as age also play a role, as chronic pain commonly affects older adults. With over half (53.4%) of all Michigan veterans being 65 or older, many within the veteran community are at risk for, or are living with, chronic pain.

Chronic pain impacts an individual's quality of life by affecting their ability to conduct daily activities, work, socialize or sleep. It may also affect a person’s mental health, leading to increased risk for depression, anxiety, substance use disorder or suicide. For years, opioids were used to manage chronic pain among veterans. This led to opioid overuse and/or misuse. The Veteran Health Administration (VHA) has since “made significant progress in reducing opioid prescribing and increasing the focus on non-pharmacological approaches.” Two alternative approaches suggested by the VHA for chronic pain management are mindfulness-based stress reduction, shown to reduce pain intensity and depression, and exercise/movement therapy, which can help reduce chronic pain and help with functioning.

Michigan State University (MSU) Extension offers multiple evidence-based health programs to diverse communities, including veterans, statewide. The following programs, with funding support from a State Opioid Response grant, are free for anyone to attend. Both incorporate non-pharmacological approaches for stress-reduction and chronic pain relief, and would benefit veterans living with chronic pain:

1. Stress Less With Mindfulness: A five-week series that introduces mindfulness concepts and practices to reduce stress and its related symptoms (e.g., anxiety and physical tension). Sessions include:
   • Begin with a Breath: Details the benefits of mindful breathing, discusses the effect of stress, and shares mindful breathing and movement practices to calm the nervous system.
   • Mindful Eating: Shares mindful eating basics and healthy options and practices mindful attention to hunger/fullness/eating to promote health and wellness.
   • Mindful Walking/Thought Surfing: Explains how walking with attention to step and breath can bring one into the present moment and discusses how “thought surfing” can help one let go of troublesome thoughts and sensations. 
   • Be Kind to Your Mind: Helps participants develop their “detached observer,” practice self-compassion, foster an attitude of gratitude and tame an overactive mind.
   • Laughter is Good Medicine: Encourages mindful laughter to de-stress and improve one’s social, emotional and physical health.  

2. Chronic Pain Personal Action Towards Health (PATH): A six-week workshop that provides various tools and a supportive environment for participants to become effective self-managers of their chronic pain. Examples of tools provided during the series include:
   • Distraction and Guided Imagery Activities: Participants explore the power of the mind-body connection to relax, relieve pain, manage troubling thoughts or worries, fall asleep or get back to sleep.
   • Body Scans and Breathing Techniques: These calm the brain and nervous system, loosen tense muscles and promote relaxation by intentionally slowing down breathing.
   • The Moving Easy Program (MEP): Offers a sequence of 26 moves designed to safely improve flexibility, gently strength train, loosen joints/muscles and increase circulation.

The Chronic Pain PATH program discusses other tools such as pacing and planning, problem solving, decision making, action planning, understanding emotions, medication, communication, navigating the healthcare system, healthy eating and getting better sleep. All these tools serve to help reduce chronic pain symptoms and to improve a person’s overall quality of life. A diverse group of MSU Extension educators and instructors regularly offer Stress Less with Mindfulness or Chronic Pain PATH classes. To find a class, explore virtual events on the Remote Learning and Resources page.