Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans
Abstract
1. Background
1.1. Military Culture, Mindset and Identity
1.2. Conceptual Framework: Identity Change
2. Methods
2.1. Approach
2.2. Sample and Recruitment
2.3. Data Collection
2.4. Data Analysis
3. Findings
3.1. The Three Chronic Pain Trajectories for Canadian Veterans
3.2. Trajectory 1: Traumatic Injury -> Immediate Discharge
“they screw up our calculations or don’t give us something we were supposed to get. You know, it’s constant with these guys…Yeah, so the government tends to drag their heels on that a lot, and it was never fun seeing our prime minister tell us that we’re asking for too much or more than they can give. That was a load of crap” [7257-Army].
“I wasn’t treated fairly…I think when I left, it was I felt like I was leaving with a bad mark to my name… he [supervisor] would berate me, belittle me, threaten my career, saying that ‘I’m going to make sure you’re released and you’re going to get nothing when you go’” [6009-Air Force].
“There was no real transition leaving the military to becoming a civilian. I was pretty much left to figure it out myself…I would let me hair grow longer, I wouldn’t iron my clothes, shine my boots… I just had an attitude” [6009-Air Force].
“my military service did not transition into a civilian job…there was no way I was going to get straight out of the military and walk into another job” [7149-Navy].
“I think it was just a kind of a swan song [at the VA], just to say goodbye, because I’m going to do something real stupid” [7149-Navy].
“Sitting in a bureaucratic process waiting for your life to be adjudicated as having worth or not is fucking painful” [3528-Army].
“this total distrust of the medical system and a further distrust of the administrative system like all piles in and so you know depression … regret of everything you’ve done thus far, you know, regretting getting hurt, regretting not taking better care of yourself, or regretting not making more of your career, and then massive amounts of anxiety for fear of the future” [3528-Army].
3.3. Trajectory 2: Misdiagnosed or Non-Traumatic Injury -> Delayed Discharge
“I guess you can in basic training… breaking you down, building you back up again to be military, but when they release you back into the civilian world, they don’t counter that, right? They don’t do anything to untrain you. From being institutionalized in the military, it’s just there’s the door, go use it. And then you’re out on the street. And then you’re without a doctor, without, you know, without anything, it’s this, there you go. There’s the door” [3735-Army].
“It was a real hard pill for me to swallow. My vision for my time in uniform was to stay in until I was 60. I had actually signed a contract CRA 60 to I had elected to stay in until age 60, because I love the work. I love the opportunities that the work gave me. You know, all my brothers and sisters that I grew up with were in uniform, you know, you know, the military was my family, you know. And when all of that stopped in [year of release], it was really difficult. I was not a happy person, you know, yeah, not happy at all” [6150-Army/Air Force].
“Throughout my entire training, my 30 plus years in uniform, and all the training that went with it, we were never taught what failure looks like. We were never taught how to fail …and how you accept that, how you rationalize that, how you understand that [failure]?” [6150-Army/Air Force].
“My focus in life had totally changed because of that two-year caregiving period and watching the fragility of life…And when I went back to work and walked in and looked at my boss and put in retirement papers on his desk and said, in six months time, I’m going be a memory. I said, I can’t do this anymore. It’s a young man’s game. Let the young fellas pick up the torch and run with it, because I’ve given my time, both mentally and physically, and I need to start living for me.” [8775-Military Police].
“I grew up with this in the back of my mind that if I, you know, sought out treatment for anything, I was weak. I wasn’t as strong as my brothers and sisters in uniform and so … [I] suffered from severe, chronic pain, fatigue and exhaustion every day. And I did all those things, and nobody would have known that there was anything wrong with me, you know, because I wouldn’t let them, I wouldn’t let them” [6150-Army/Air Force].
“And military people don’t bitch and complain, because I was taught that pain is nature’s way of telling you you’re still alive. Don’t argue with it. Suck It up. Get on and capture the objective. That’s what the infantry does, right? So, you just do that. You self medicate out the wazoo and carry on” [2791-Army].
“Yeah, pop some Tylenol and carry on. That’s the problem with, you know, being in the military, it’s suck it up and get back to work and, you know, and, and, of course, unfortunately, being a female, you know, you can’t show any weakness, because then the sharks gather in the water. So, and especially as a female leader, there’s even that much more pressure on you to perform at a higher level than your male counterpart” [1652-Army].
3.4. Trajectory 3: Cumulative ‘Wear and Tear’ -> Gradual Discharge
“And then I spent another day in bed, in the tent, because I didn’t want to take a hospital bed and so and then I went back to work again, doing everything again, trying to using painkillers. The military seem to like to patch you up with muscle relaxants and opioids” [8173-Air Force].
“[There was a moment that] broke the glass and it was almost instantaneous where everything that had maybe been a dull roar before was now screaming the pain…I think of it as being a slow progression, and when I stopped to realize that, you know, all this stuff is real, it was immediate. It became, you know, like screaming pain versus the dull roar that I was trying to ignore” [7864-Air Force].
“It [transition squad] took me out of my environment…so that I could slow down and catch up with what is going on in my body…it gave me the chance to understand what was going on, and that’s where I was diagnosed with high blood pressure and some other things…[but] it was really hard that I took a big hit with that mentally, because I’ve always been active my entire life to suddenly being so disabled, it was really hard” [7864-Air Force].
“And it was like I was reinjuring myself every, you know, not every time, but periodically, just reinjuring the neck and back. And it just never, never really improved” [6009-Air Force].
“We weren’t trained to worry about our feelings…you know, it was mission first. That was it, you know, mission before self. And it was just sort of drilled into you. You were just, it was physical. You were expected to be hurt. You were expected to freaking have bumps and bruises, and that’s just the way it was. And especially in the combat arms, if you can’t perform on the physical aspects, man, you better be prepared for it, because you’re definitely going to get rode hard and freaking, you won’t last if you can’t perform physically” [4119-Army].
4. Discussion
4.1. Developing Veteran-Centred Systems and Services Using Pain Trajectories
- After immediate discharge for traumatic injury, chronic pain can create the conditions for identity loss and contest the legitimacy of women whose sacrifice is constantly doubted.
- With injuries that do not trigger immediate discharge, women often stay in uniform, mask pain to meet “toughness” expectations, and later navigate a fractured self.
- With cumulative wear and tear, pain is often the least credible, amplifying disbelief, self-doubt, and invisibility.
4.2. Strengths and Limitations of This Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | n [%] | |
---|---|---|
Gender | Man | 15 [75.0] |
Woman | 5 [25.0] | |
Age | Mean | 57.16 years |
Median | 56 years | |
40–49 | 3 [15.0] | |
50–59 | 9 [45.0] | |
60+ | 8 [40.0] | |
Race/Ethnicity | White | 17 [85.0] |
Non-White | 3 [15.0] | |
French | 2 [10.0] | |
Province | Alberta | 6 [30.0] |
British Columbia | 2 [10.0] | |
Nova Scotia | 2 [10.0] | |
Ontario | 6 [30.0] | |
Quebec | 3 [15.0] | |
Saskatchewan | 1 [5.0] | |
Rurality | Urban | 9 [45.0] |
Suburban | 4 [20.0] | |
Rural | 7 [35.0] | |
Highest Education | High school | 6 [30.0] |
College | 6 [30.0] | |
University | 5 [25.0] | |
Graduate | 3 [15.0] | |
Years of Service | Mean | 24.08 |
Median | 24 | |
0–9 | 2 [10.0] | |
10–19 | 4 [20.0] | |
20–29 | 7 [35.0] | |
30+ | 7 [35.0] | |
Year Released | Median | 2016 |
Mode | 2019 | |
≤1999 | 3 [15.0] | |
2000–2009 | 3 [15.0] | |
2010–2019 | 12 [60.0] | |
≥2020 | 2 [10.0] | |
Military Units * | Army | 15 [75.0] |
Air Force | 5 [25.0] | |
Navy | 3 [15.0] | |
Military Rank | Corporal | 5 [25.0] |
Sargent | 7 [35.0] | |
Master Warrant Officer | 1 [5.0] | |
Captain | 1 [5.0] | |
Major | 5 [25.0] | |
Colonel | 1 [5.0] | |
Chronic Pain Location Based on Diagnoses Self-Reported by Veterans | Back | 19 [95.0] |
Knees/Legs | 13 [65.0] | |
Ankles/feet | 7 [35.0] | |
Hips | 6 [30.0] | |
Neck | 5 [25.0] | |
Elbows/Arm | 5 [25.0] | |
Wrist/Fingers | 3 [15.0] | |
Shoulder | 2 [10.0] | |
Jaw | 1 [5.0] |
Traumatic Injury -> Immediate Discharge | Misdiagnosed/Non-Traumatic Injury -> Delayed Discharge | Cumulative ‘Wear and Tear’ -> Gradual Discharge |
---|---|---|
Veterans in this group experienced abrupt identity disruption when sudden injuries led to early medical release. Their pain was compounded by financial and occupational vulnerabilities, bureaucratic hurdles in securing benefits, and a lingering sense of betrayal by the institution. The immediate severing of ties with military life left many struggling to adjust to civilian life with unresolved grievances. | These Veterans remained in uniform for years despite chronic pain from misdiagnosed or undertreated injuries. They described conflict between the military ethos of strength and their physical limitations, creating identity dissonance and prolonged uncertainty. The drawn-out transition often left them unprepared for discharge, carrying frustrations about missed diagnoses and insufficient institutional support. | For Veterans with slowly developing pain, the lack of a clear injury made their conditions less visible and harder to validate. They faced delayed diagnoses, piecemeal medical care, and cultural pressure to “push through” pain. This invisibility left many feeling alienated, with protracted transitions out of service marked by exhaustion, regret, and doubts about whether the institution truly acknowledged their suffering |
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Share and Cite
Majid, U.; Hoppe, T.; Priest, P.; Lacroix, L.; Held, N.; Pedlar, D.; Kuluski, K. Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans. Healthcare 2025, 13, 2655. https://doi.org/10.3390/healthcare13202655
Majid U, Hoppe T, Priest P, Lacroix L, Held N, Pedlar D, Kuluski K. Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans. Healthcare. 2025; 13(20):2655. https://doi.org/10.3390/healthcare13202655
Chicago/Turabian StyleMajid, Umair, Tom Hoppe, Phoebe Priest, Leane Lacroix, Nicholas Held, David Pedlar, and Kerry Kuluski. 2025. "Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans" Healthcare 13, no. 20: 2655. https://doi.org/10.3390/healthcare13202655
APA StyleMajid, U., Hoppe, T., Priest, P., Lacroix, L., Held, N., Pedlar, D., & Kuluski, K. (2025). Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans. Healthcare, 13(20), 2655. https://doi.org/10.3390/healthcare13202655