Posted on: Apr 15, 2020
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When patients and colleagues ask me about the origins of the Chronic Pain Centre of Excellence for Canadian Veterans (“Centre of Excellence”), I start by telling them a story of an early patient of mine at the Michael G. DeGroote Pain Clinic.

This patient was a veteran, so I asked him when he started working for the Department of National Defense (DND). He quickly corrected me that he never worked for the DND – he served. This is more than a simple word choice of career versus service; the idea of serving your country is a mindset that is embedded into every veteran. When our military men and women are pulled out of their service due to a medical injury, they don’t just lose the daily structure and connection to military family, they also lose their sense of self because they can no longer serve.

I’d been working with the Department of National Defense since 1994 and treating chronic pain at the Michael G. DeGroote Pain Clinic since 2012, but treating veterans with chronic pain opened my eyes to the service and sacrifices our military men and women make, all so that average Canadians like me can live in peace and safety.

I am fortunate to be part of a community of leading chronic pain clinicians and researchers with Hamilton Health Sciences and several organizations led by McMaster University, including the Michael G. DeGroote Pain Clinic, the Michael G. DeGroote Institute for Pain Research and Care, the National Pain Centre, and the Centre for Medicinal Cannabis Research. The Michael G. DeGroote Pain Clinic has been working with Veterans Affairs Canada (VAC) to treat veterans with chronic pain for over 30 years. Our chronic pain research and care delivery follows the “Biopsychosocial Model,” which views pain as a dynamic interaction among the biological, psychological, and social factors unique to each individual. This interdisciplinary model has been applied to civilians with chronic pain since the 1970s, and the focus on treating chronic pain holistically is widely accepted among researchers and practitioners.

What is novel about the Biopsychosocial Model is how especially effective it is in treating veterans with chronic pain because of the nature of military service and its impact on both the body and the mind.  

From treating veterans with chronic pain, our teams have learned that while every case is unique, the common thread is that many of the veterans we treated have lost hope. They felt isolated from their military family, lost in their own bodies, and abandoned by the system.

However, we saw that the best success in applying the Biopsychosocial Model to chronic pain management has been among veterans. As articulated by the Pain Clinic’s clinical psychologist Eleni Hapidou, we can hypothesize several reasons for this: veterans have a tendency to push through the pain, which can exacerbate physical injuries but also means they don’t quit when it comes to the treatment; they thrive when they have a support system, but often experience an uneasy psychosocial transition from active military service to civilian life upon being medically released; lastly, the veteran peer-to-peer network is very tight, which means that veterans are likely to share the best practices and recommendations that work for them with other veterans in the community.  

With our site’s unique set of capabilities in chronic pain research and our expertise treating veterans through VAC, we worked with VAC to scale-up our learnings and practical insights and established the Chronic Pain Centre of Excellence for Canadian Veterans to conduct research into chronic pain among veterans at the national level.

Ever since that early veteran patient taught me about service, I start every new treatment by thanking a veteran for their service. Now, with the Centre of Excellence, we can serve those who have served us.

The Chronic Pain Centre of Excellence is funded by the Government of Canada.

About the Author: Dr. Ramesh Zacharias is the President, CEO, and Medical Director of the Chronic Pain Centre of Excellence for Canadian Veterans. He has worked with the Department of National Defense since 1994 and has treated veterans since 2012 at the Michael G. DeGroote Pain Clinic at McMaster University.

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