VISN 2: Veterans' Wellness, Fall 2011
Ask the Expert:
Karl Frohm, Ph.D., Chairman
VA Health Care Upstate New York
Pain Management Advisory Council
Karl Frohm Ph.D.
Q. Is pain a major factor for
U.S. Veterans returning from
Iraq and Afghanistan?
A: Yes. In some studies, physical pain
is the most prevalent symptom
reported to VA health care providers
by returning servicemembers. Many
factors surrounding the current
international conflicts contribute
to this increase in pain symptoms,
including injuries from explosives
and back and knee problems caused
by carrying heavy equipment.
Q. What is the difference
between acute pain and
A: Acute pain is an immediate result of
harm or injury to the body. In most
cases, it improves as the injury heals
or irritation is removed. Soldiers on
the battlefield may receive aggressive
drug treatment for acute pain
to ensure a quick return to duty.
Chronic pain continues for weeks,
months, or years despite the fact that
the original injury has healed. When
a Veteran returns home and comes
into a VA clinic complaining of pain,
we’ll address this problem through a
comprehensive personalized treatment
plan. The focus of chronic pain
management is to improve a Veteran’s
functioning and quality of life.
Q. How is VA addressing pain issues and tracking drug treatments?
A: Whether a Veteran’s pain involves
muscles, joints, bones, organs, skin,
or nerves, VA has made treating acute
and chronic pain a priority. Pain
management begins with a Veteran’s
primary care provider, who assesses
sources of pain and risk factors for various pain treatments in forming
a plan of care with the Veteran. The
primary care provider also monitors
safety and effectiveness of treatment,
including how it affects the
Veteran’s quality of life. Pain specialists
are available to work alongside
VA primary care providers to provide
additional care. VA pharmacists use
sophisticated electronic systems to
track prescribed medications and
ensure patient safety.
Q. Are opioid medications the main treatment used for pain?
A: No. Opioids are one part of pain treatment and may not be helpful for some patients or pain problems. Other pain treatments include medications to reduce inflammation or calm irritated nerves, physical therapy to improve strength and movement, anesthetic injections to temporarily relieve pressure or block pain signals from reaching the brain, and cognitive or behavioral tools to reduce pain and stress or help Veterans cope with pain.
Q. Do opioids carry a risk
A: Yes, there is some risk for addiction,
especially for people with prior
drug abuse problems. However,
there are other risks associated
with opioids that are equally
or more important. Before
Veterans are prescribed opioids,
they are evaluated for
medical or psychological
factors that could
make opioids unsafe
for them. Veterans
prescribed opioids should expect to have a structured
relationship with their health care
provider, including being asked to sign
a treatment agreement or to undergo
drug testing to ensure that the medication
is being used appropriately.
Q. What can Veterans do to
optimize pain relief?
A: To get the most out of your treatment,
you are encouraged to
participate in every aspect of your
care. For example, take medications
as directed, attend therapy sessions,
and apply new techniques at home.
Don’t allow pain to overtake your
life. Your Patient Aligned Care Team
(PACT) can connect you with VA
specialists who can help to relieve
unresolved pain and help you to live
your life well with ongoing pain.
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