How do the DoD and VHA treat pain?
The DoD and the VHA use a “Stepped Care“ approach to pain. That is, different treatments may be offered to you based on the type, length, and cause of pain. How your pain is treated is also affected by possible side effects and cost of treatments. The treatment/management of your pain will be specific to you, and it may involve more than one kind of treatment from more than one healthcare provider. These documents from the DoD’s Pain Management Task Force and VHA Directive 2009-053 provide additional information.
Below is a brief model of the Stepped Care approach to pain:
Step 1: Primary Care Team
Types of pain: Acute
Treatments: low-risk medication, physical/occupational therapies, self-care and mind-body techniques
Step 2: Pain Specialists
Types of Pain: Long-term acute, potentially chronic
Treatments: Step 1 treatments, plus injections, medication, minor surgeries
Step 3: Integrated Pain Team
Types of Pain: Chronic
Treatments: Steps 1 and 2 treatments, plus major surgeries, mental health care, medications