The Experiences of Women Canadian Armed Forces Service Members and Veterans with Comorbid Chronic Pain and PTSD: A Qualitative Inquiry

Abstract

Chronic pain and posttraumatic stress disorder (PTSD) frequently co-occur among service members and veterans. Evidence suggests that women service members and veterans are more likely to experience comorbid chronic pain and PTSD than their men counterparts. Theoretical models of comorbid chronic pain and PTSD suggest the conditions may maintain and exacerbate each other, creating a unique clinical interaction that worsens outcomes and complicates treatment. Given women military personnel experience these comorbid conditions at elevated rates, there is a particular need to illuminate their narratives. The current study aimed to qualitatively explore the experiences of women service members and veterans with comorbid chronic pain and PTSD to identify potential connections between chronic pain and PTSD. It also sought to examine issues that affect military women more acutely (e.g. military sexual trauma) that may be uniquely impacting their experience of the conditions. Nineteen Canadian Armed Forces (CAF) service members and veterans participated in one to one and a half hour semi-structured interviews about their experiences of comorbid PTSD and chronic pain. This study selected the transcripts of women service members and veterans (n = 6) and applied interpretive description, a qualitative methodology that aims to produce interpretive insights that enhance clinical understanding. Thematic analysis was used to extract exemplars to identify themes within the data. The analysis identified three main themes. The first theme described ways in which the conditions were related, such as one condition triggering the other. The second theme illustrated participants’ feelings of betrayal by the military, which complicated the way they experienced their pain and trauma. The third theme described participants’ struggles with accepting their pain and trauma, which was layered by feelings of betrayal, military culture, and self-identity. By capturing lived experiences, this study provided crucial insight into women CAF service members’ and veterans’ unique challenges in living with chronic pain and PTSD. Findings reflected portions of theoretical models of comorbid chronic pain and PTSD and identified novel ways in which the conditions were linked. This study offers clinical perspectives to inform the care of Canadian women service members and veterans living with these conditions.