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As in the general population, chronic pain is a prevalent and burdensome affliction in active-duty
military personnel. Painful conditions in military members can be categorized broadly in terms of
whether they arise directly from combat injuries (gunshot, fragmentation wound, blast impact) or
whether they result from non-combat injuries (sprains, herniated discs, motor vehicle accidents).
Both combat-related and non-combat-related causes of pain can further be classified as either
acute or chronic. Here we discuss the state of pain management as it relates to the military
population in both deployed and non-deployed settings.
The term non-battle injury (NBI) is commonly used to refer to those conditions not directly
associated with the combat actions of war. In the history of warfare, NBI have far outstripped
battle-related injuries in terms not only of morbidity, but also mortality. It was not until
improvements in health care and field medicine were applied in World War I that battle-related
deaths finally outnumbered those attributed to disease and pestilence. However, NBI have been
the leading cause of morbidity and hospital admission in every major conflict since the Korean
War.
Pain remains a leading cause of presentation to military medical facilities, both in and out of
theater. The absence of pain services is associated with a low return-to-duty rate among the
deployed population. The most common pain complaints involve the low-back and neck, and
studies have suggested that earlier treatment is associated with more significant improvement and
a higher return to duty rate. It is recognized that military medicine is often at the forefront of
medical innovation, and that many fields of medicine have reaped benefit from the conduct of war.
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