Many military personnel and veterans experience chronic pain, a condition that can be debilitating and often difficult to treat. Service members may have other conditions that are also challenging to treat including, post-traumatic stress disorder (PTSD), anxiety, depression, insomnia, and substance use disorder. Many military personnel, veterans, and their families turn to complementary and integrative health approaches such as mindfulness meditation and other practices to increase their options for the management of pain and associated problems.
Research on complementary health approaches for chronic pain in military populations is currently in progress, but there is very little published information about the effectiveness of these approaches for chronic pain in military populations. However, there is published information on complementary health approaches for PTSD, stress/anxiety, and insomnia in military personnel and veterans, as well as information on chronic pain in non-military populations.
Here are 8 things to know about mind and body approaches for health problems facing military personnel and veterans.
- Reviews of research on acupuncture, massage, spinal manipulation, and yoga for chronic low-back pain in non-military populations have found evidence that these therapies may be beneficial. There is also some evidence that mindfulness-based stress reduction and cognitive-behavioral therapy improves pain and function compared to usual care.
- Spinal manipulation. The most recent guidelines from the American College of Physicians conclude that there is some evidence that spinal manipulation may be associated with a small improvement in function, but there may be no difference between spinal manipulation and other active treatments.
- Acupuncture. These same guidelines recommend that patients with chronic low-back pain initially select nonpharmacologic treatment, such as acupuncture, to help manage their pain. In many studies, acupuncture has shown some benefit for low-back pain compared to conventional therapy, but simulated (placebo) acupuncture has also shown a similar benefit, suggesting that a component of any benefit from acupuncture may be due to patient expectation or practitioner attention.
- Massage. Studies suggest that massage is associated with short-term beneficial effects in reducing pain and improving function compared to usual care in people with chronic low-back pain.
- Yoga. A 2017 review of studies found that there is some evidence that yoga compared to non-exercise (e.g., no treatment, delayed yoga treatment, or patient education) results in small to moderate improvements in back-related function at 3 and 6 months, and may also be slightly more effective for pain, but the effect size was very small.
- Mindfulness-based stress reduction. A new study in adults with chronic low-back pain found that mindfulness-based stress reduction and cognitive-behavioral therapy resulted in greater improvement in pain and functional limitation compared to usual care.
- Available evidence indicates that acupuncture for neck pain may provide better pain relief compared to no treatment. There is some evidence that spinal manipulation may help relieve neck pain, but much of the research on has been of low quality.
- According to reviewers who have assessed the research on complementary health practices and fibromyalgia, much of the research is still preliminary, and evidence of effectiveness for the various therapies used is limited. However, research has shown that tai chi may provide a benefit to patients with fibromyalgia.
- There is some limited evidence that mind and body practices such as progressive relaxation, hypnosis, imagery, biofeedback, and visual mirror feedback may be useful in reducing phantom limb pain and sensation in amputees, although most studies have been small and of low quality.
- Clinical guidelines on the management of post-traumatic stress disorder (PTSD) issued in 2010 by the Department of Veterans Affairs and the Department of Defense indicate that relaxation techniques be considered as a part of treatment approaches for acute stress disorder or PTSD in relieving symptoms associated with physiological hyper-reactivity.
- There is some limited evidence that some mind and body approaches, such as yoga, meditation, and relaxation techniques, may have the potential for modest beneficial effects on stress and anxiety in military populations. However, many of the studies have small sample sizes.
- There is some evidence to suggest that relaxation techniques, along with behavioral therapies, can be helpful components of a successful strategy to improve sleep, but there have only been a few small studies conducted in military populations. There is also some limited evidence that imagery rehearsal therapy may improve insomnia in nonveteran populations, but only a few small studies have examined imagery rehearsal therapy in combat veterans or active duty military personnel.
- Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.