The transition to civilian life in the context of chronic pain: Qualitative and exploratory research

Abstract

Introduction:

The transition from military to civilian life can be a significant challenge for Canadian Armed Forces (CAF) Veterans, with approximately 39% experiencing difficulties. Veterans living with chronic pain face unique challenges during this transition, with impacts on their physical, mental, and social well-being. This study explores the experiences and needs of Veterans living with chronic pain during their transition to civilian life and examines the implications of chronic pain on various life domains.

Methods:

This qualitative and exploratory study investigated the effects of chronic pain on CAF Veterans’ transitions to civilian life. Two three-hour focus groups were held with Veterans (N = 8) to explore their experiences with pain and its impacts on their social functioning during the transition to civilian life. Data were analyzed using thematic analysis.

Results:

Participants reported stigmatization of pain during military service, challenges in accessing civilian health care, significant emotional and relational impacts of chronic pain, and the importance of adaptive coping strategies. Participants also highlighted the need for peer support programs and specialized chronic pain clinics to facilitate the transition to civilian life and improve Veterans’ quality of life.

Discussion:

Chronic pain significantly complicates CAF Veterans’ transitions to civilian life by affecting various aspects of life and adjustment processes. The findings underscore the need for enhanced access to civilian health care and Veterans Affairs Canada services, along with preventive interventions, to support Veterans’ well-being and facilitate successful transitions.

Lay Summary

Transitioning from military to civilian life is challenging for Canadian Armed Forces Veterans, particularly those with chronic pain. This study explored how chronic pain affects Veterans’ well-being and adjustment during this transition. Veterans reported stigmatization of pain during service, difficulties accessing civilian health care, and emotional and relational challenges. Peer support programs and specialized pain clinics would help to ease this transition and improve Veterans’ quality of life. Improved access to health care and preventive measures are essential to help Veterans live healthier, more fulfilling lives after their military careers.

Introduction

Veterans undergo a major transition when they are released from the Canadian Armed Forces (CAF): the transition from military to civilian life. Although there is no standard definition for the military-to-civilian transition (MCT), it is generally recognized as a process in which a person leaves military service and adjusts to civilian life.1 The MCT generates several changes in the lives of Veterans who experience it. They often need to redefine their identity, organize their time differently outside the CAF’s structured routines, find ways to value themselves outside of military service, and renegotiate their social connections.^2–4 Although this transition generally goes well for the majority, around 39% of Veterans find it difficult to adjust to civilian life.5 These Veterans may experience a decline in their overall quality of life, a deterioration in their physical and mental health, and impaired social functioning.6 These difficulties are more likely to occur among Veterans with chronic health problems, such as constant and reoccurring chronic pain,^7,8 which affects about 64% of Veterans.9 The MCT was, moreover, identified in 2021 as a research priority by the Pain Centre of Excellence for Canadian Veterans.10 It thus seems important to investigate the impact of chronic pain on the transition from military to civilian life; however, very few qualitative studies go beyond statistics to provide a clear understanding of how Veterans living with chronic pain experience this transition. Therefore, the purpose of this article is to describe the experiences and needs of Canadian Veterans living with chronic pain as they transition to civilian life and to explore the impact of their pain on various aspects of their lives.

Methods

The results of this article are drawn from qualitative, exploratory research conducted from 2022 to 2024. Its objective was to explore the impact of chronic pain on CAF Veterans’ transition to civilian life.

Sample and recruitment

Participants were recruited through a partnership with the Quebec Veterans Foundation and through snowball sampling on social networks. The study’s eligibility criteria were as follows: have been a Regular Force member of the CAF, are in the process of being released or have been released for medical reasons within the past 10 years, live with chronic pain on a daily basis, and can understand and express themselves in French. Potential participants were contacted by the first author to confirm their participation and explain the study procedure. An information and consent form was then emailed for signature before participation in the focus group. This research project was approved by the Université Laval Research Ethics Committee (2024–011).

Data collection

Data were collected through two focus groups led by the first and second authors; each focus group lasted three hours. The first was conducted face to face, and the second was conducted in hybrid mode. The hybrid format was chosen to facilitate the participation of individuals residing in rural regions of Quebec and those with functional limitations that prevented in-person attendance. The platform used was Zoom. With participants’ consent, the meeting was recorded and stored on secure servers for subsequent analysis. One group was conducted with male Veterans and the other with female Veterans to ensure a safe space for all, considering the sexual misconduct reported by several CAF military members during their service.^11,12

The interview guide for the focus groups was based on a literature review and the theoretical framework of the study. The theoretical framework of the study is based on life course theory. This theory, formulated by Elder and colleagues,13 describes a person’s life as a journey made up of different trajectories, such as personal, interpersonal, professional, and health trajectories. When an important event occurs, a person may experience a transition, that is, a change, in social roles in one or more of their life trajectories. The concepts of trajectories and transitions were mobilized to explore how the transition to civilian life affects the different domains of Veterans’ lives. Four themes were explored in the focus groups. Table 1 shows some of the questions associated with each theme.

Table 1.

Extracts from the interview guide

Theme	Question
1. Experience of pain	• What does pain mean to you? • How do you think your experience with the CAF has influenced your relationship with pain?
2. Impact of chronic pain on social functioning	• How does pain affect your everyday life? • What do you think are your most important needs to be able to live the life you want despite persistent pain?
3. Transition to civilian life	• How has your transition to civilian life been? • Do you feel that pain has affected your transition to civilian life? If so, how, and if not, why?
4. Transition from military to civilian care	• What was your transition to civilian care like? • How do you rate your care in the civilian health care system? Is it adapted to your reality? • What could have helped you, or could help you, to make this transition easier (information, ways of doing things, services)?

CAF = Canadian Armed Forces.

Data analysis

The focus groups were audio recorded and transcribed verbatim. A thematic analysis of the data using the method of Paillé and Mucchielli was then carried out.14 After several readings of the transcripts to highlight the main ideas of the corpus, the first author created a thematic tree according to a mixed model. That is, it was first based on the theoretical framework of the present study by identifying turning points in personal, interpersonal, professional, and health trajectories, and then, in a second phase, it was enriched by themes that emerged during the readings done by the first author.8,15 The thematic tree was then validated by the second author, who reread the transcripts in their entirety to see whether anything was missing from them. The second author also enriched the thematic tree by providing insight based on her own experience as a Veteran who went through the transition to civilian life with chronic pain. Subsequently, the entire corpus was systematically coded with the thematic tree by the first author. The coding was done manually using annotation and underlining in a text processing program. The transcripts from both groups were analyzed collectively, to highlight the collective experience of the impact of chronic pain on participants’ transition to civilian life. Gendered differences, however, were considered and are incorporated directly into the results. Once the transcripts had been fully analyzed, all similar themes were grouped together to produce the four main themes presented in the Results section. To ensure rigour and trustworthiness, the third and second authors reread the corpus to validate the first author’s analysis. Meetings were organized if the authors raised different interpretations, and decision-making about disagreements was reached via a consensus method. The results were also sent to the participants for further validation, and they all agreed that the themes faithfully reflected what they had said during the focus groups.

Results

Four male and four female Veterans participated in this study. All were medically released and had served the CAF in the Regular Forces between 10 and 34 years. Four main themes — the army and pain, the transition to civilian life, living with chronic pain, and recommendations for the transition to civilian life in the context of chronic pain — are presented in the following sections. The sociodemographic profile of each participant is presented in Table 2. It should be noted that participants 1 and 6 withdrew from the study before the focus groups, and that participants 8 and 10 live with chronic daily pain. However, at the time the focus groups were conducted, only their post-traumatic stress disorder was officially recognized as a disability by Veterans Affairs Canada (VAC). All quotes are presented in French, their original language. A table containing English translations is available at the end of the paper (see Appendix 1).

Table 2.

Profile of participants

Participants	Gender	Age, y	Years of service	Release year	Certified disabilities
P2	Male	51-65	≥26	2020	Chronic pain
P3	Male	36-50	≥26	2021	Chronic pain, chronic illness, PTSD
P4	Male	36-50	20-25	2016	Chronic pain, PTSD
P5	Male	36-50	20-25	2021	Chronic pain
P7	Female	36-50	20-25	2020	Chronic pain
P8	Female	36-50	10-19	2023	PTSD*
P9	Female	36-50	10-19	2024	Chronic pain, PTSD
P10	Female	36-50	10-19	2018	PTSD*

Note: Participants 1 and 6 withdrew from the study before the focus groups occurred.

^*Participants 8 and 10 live with chronic pain on a daily basis, but when the focus groups were conducted, only their PTSD was recognized as a certified disability by Veterans Affairs Canada.

PTSD = posttraumatic stress disorder.

Theme 1: The army and pain — bodies as prematurely worn machines

According to the participants, the military culture in place during their years of service was one of stigmatization in the face of pain. Soldiers were encouraged to be strong and show no signs of weakness, as this Veteran testified:

Quand on est militaire, on n’a pas le droit à des faiblesses. Si on en a, on les cache ou on les vit tout seul. … On veut être un vrai soldat guerrier. (P10)

Soldiers who claimed to be unable to take part in training for health reasons were forced to dress up in parade outfits to be identified as weak in the eyes of others:

Ils appelaient ça la parade des malades le matin, à 7 h du matin. … C’était comme une ségrégation. (P2)

To avoid this sick parade and the judgment of their peers, several participants endured pain despite their injuries. For many, this stigmatization of pain was also reflected in the care they received during their career. When they went to medical services because of pain, little assessment was carried out. Instead, they were given medication and told to get on with their work:

Tu rentrais : « ah j’ai mal à telle place. » … « Tiens, Naproxen. » (P5)

This downplaying of health issues, according to the participants, was even more pronounced among female Veterans. Their physical symptoms were frequently invalidated because there was a biased view that they worked less than male Veterans:

Dans leur tête … on est des petites filles, donc si c’est pesant, ben les ti-gars vont porter pour nous autres. Sauf que la réalité dans l’armée, c’est one man one kit. Donc ton kit, tu le traines. (P9).

This minimization of pain and the lack of appropriate responses from CAF medical services led many participants to push their bodies until they collapsed:

C’est que la machine, tu la pousses tout le temps tout le temps jusqu’à tant que tu fesses le mur … on a trop encaissé et on a fessé le mur. (P2)

It should be noted that several participants had both chronic pain and operational stress injuries. For many, these two conditions developed simultaneously as a result of the conditions in which they served and the traumas they experienced. They also interacted with and exacerbated each other, leading the participants to a point of no return:

Ça allait bien ma carrière, mais quand j’ai commencé à avoir un paquet de rendez-vous, là c’était plus la même game. (P3)

This was often the beginning of the end of their careers and led many to an unwanted medical release. Although they faced the same problems as male Veterans, female Veterans were more attuned to their needs and aware of their limitations. This self-awareness seemed to have helped them to some extent to resist the demands to constantly exceed their capabilities and made it easier for them to accept the idea of leaving the CAF to prioritize their well-being, thereby facilitating their transition to civilian life.

Theme 2: The Transition to civilian life — rediscovering oneself in an organizational maze

All the participants in the study were released for medical reasons, either because they were in too much pain or because they were no longer able to meet universal service requirements. For most of them, this transition was far more difficult than the end of a regular job:

Quand je suis sortie des Forces, c’était comme une dépression. C’est un deuil, là. J’étais couchée, je mangeais des spaghettis et j’écoutais des séries toute la journée … Tout ce que j’avais construit, c’était en arrière de moi. (P10)

As this Veteran’s testimony shows, the transition to civilian life was a major loss for her. Participants had to redefine themselves outside a career that gave meaning to their lives and mourn the loss of an often highly rewarding profession. Professional grief is not the only thing participants had to mourn when they left the CAF. They also had to grieve for the army itself, which had become a family to them after many years of service:

Il y a le côté anxiété, anxiogène de quitter une famille après les nombreuses années que j’ai faites. Les amis, militaires, la famille. (P3)

Two participants mentioned that they knew they would be released several years before their official release. This more gradual transition seems to have helped them cope better. However, whether the transition to civilian life was gradual or not, all participants found it challenging to move from a military health care system to their province’s civilian health care system:

Tu passes toute ta vie dans un système de santé qui est militaire, parallèle à un service de santé civil. Du jour au lendemain,… la porte se barre. C’est terminé. (P2)

Participants also reported a lack of expertise in the civilian health care system to properly care for them. However, their main concern was finding a general practitioner after their transition, a process that could take several years. This delay in accessing care created an asynchrony with the services and compensation they could receive from Veterans Affairs Canada (VAC) because they needed to be assessed by a physician to access the latter. Participants who were able to find a general practitioner were frequently faced with a refusal to complete the necessary forms. These organizational challenges with the civilian health care system led many participants to seek private medical care. However, this involves paying money to be treated punctually and to be assessed to have access to VAC programs, which is not possible for all Veterans.

In terms of VAC services, all participants agreed that there is no lack of resources available to them. However, according to participants, one must ask for them and be proactive in accessing them, which becomes problematic for Veterans who are not able to ask for help. Participants’ use to services was also limited by the complexity of the steps required to access them:

C’est les douze travaux d’Astérix. Faut que tu te battes. Il faut que tu t’obstines, il faut que tu sois à tes affaires. (P7)

As this Veteran puts it, the resources are there, but it is a struggle to access them. Several other participants also said they were unaware of the existence of various programs, demonstrating a lack of communication that can deprive Veterans of the services to which they are entitled and that would help them live better with their chronic pain.

Theme 3: Living with chronic pain — a daily roller coaster ride

All the participants said that their chronic pain had significantly changed their lives. For some, the pain could be so severe that simple tasks such as dressing and showering became impossible at times:

Des fois, je peux être quelques jours au lit parce que je suis incapable de fonctionner. Juste d’affronter cette douleur-là, c’est exténuant, c’est brûlant, c’est épuisant. (P9)

In her testimony, this Veteran showed how severe the pain can be, to the point of forcing her to be bedridden. For most of the participants, pain also prevented them from working or pursuing their passions. The pain was accompanied by numerous losses that are likely to cause emotional pain:

C’est oui la douleur chronique, douleur émotionnelle et mentale, mais un deuil … c’est des montagnes russes je dirais. (P2)

Beyond grief, chronic pain also had a significant impact on participants’ family and social relationships, as this Veteran puts it:

La douleur chronique, ça fait que ça a éclaté ma famille … j’ai envoyé ma fille la plus jeune à son père parce que je n’étais plus apte à m’en occuper. … Mon conjoint, je reste plus avec parce que ça lui demandait de l’ajustement qu’il n’était pas prêt à faire. (P8)

This passage clearly shows how chronic pain can disrupt family relationships and how it can lead to loneliness. When chronic pain did not disrupt family dynamics, it often caused Veterans to feel guilty toward their loved ones, as this participant puts it:

Tu te frustres parce que tu dis : « je suis écœurée de me lamenter et de faire endurer ça à mon entourage que j’ai mal. » Je mine le moral de tous les gens qui m’entourent à la maison. (P9)

To face those challenges created by chronic pain, Veterans had to adopt coping strategies. For several participants, alcohol use was an important escape from pain at first:

De mon côté à moi, l’échappatoire était la Stella Artois. … Tu as beau pousser, tu as beau essayer, la douleur est toujours là. … Donc un moment donné, bien, la Stella … elle est là. Elle t’aime. Tu l’aimes. Elle ne dit pas un mot et elle t’amène du bonheur. (P2)

Alcohol use, as shown in this Veteran’s testimony, was an easy way to cope with the pain and the emotional distress it caused. However, all participants who once used this strategy had moved on to more constructive ways to cope with pain that were less detrimental to their well-being. Several Veterans cited money as an important resource for continuing to live despite their pain, as this Veteran puts it:

Il faut de l’argent pour être capable de compenser tes douleurs chroniques. J’ai toujours voulu un chalet. … Le chalet je l’ai acheté … j’ai zéro réno à faire. … Donc ça prend de l’argent pour être capable de faire ça, sinon bien tu tombes dans un creux et tu fais rien. (P3)

The money participants received from the CAF and VAC was often reinvested to compensate for the limitations caused by their pain and to enable them to continue to function daily and pursue their passions. Staying physically active to the best of their ability and engaging in meaningful activities were also cited as ways to maintain psychological well-being, even if they made the pain worse:

Même si j’ai [des crises de douleur], si j’ai besoin d’aller faire de la moto, je vais préférer aller faire de la moto … le bien-être que ça va m’avoir procuré va être plus grand que de m’en être empêché. (P7)

All participants agreed that it was important to find a balance between pain management and continuing to engage in activities that were meaningful to them, as this testimonial shows. Female Veterans also reported the presence of animals as a meaningful strategy for coping with daily challenges and finding comfort. Finally, seeking help from family and friends and maintaining meaningful social relationships were important strategies used by a large majority of participants in our study.

Theme 4: Recommendations for the transition to civilian life in the context of chronic pain — making life after military service easier

Participants had several recommendations to make the transition to civilian life and daily life with chronic pain easier. First, it was suggested that a peer helper program be set up so that Veterans with positive transition experiences could help military personnel before their transition. As this Veteran put it,

Je pense que le rôle de pair-aidant est vraiment crucial. Il est vraiment important. Parce que souvent ça va être des personnes avec qui t’as servi avant, qui ont vécu des choses, puis qui s’en sort bien malgré tout. (P8)

A peer helper program, according to the participants, could ease fears about the transition and offer positive role models for new or soon-to-be Veterans.

Second, it was suggested that the process to access VAC programs be simplified and that existing resources be better publicized:

J’ai appelé une agente de gestion de cas. Là j’ai dit : « Je vois des programmes que j’ai jamais été mis au courant à ma libération. … » Donc c’est moi qui prends l’initiative parce que je commence à me rendre compte comment ça fonctionne dans VAC et je pense que c’est juste un problème de communication parce qu’il y a tellement de programmes de disponible. (P3)

As shown in this Veteran’s testimony, every resource he needed existed. He just did not know about them before looking at the documentation himself. Better publicizing the programs offered by VAC, particularly through case management agents, would ensure that every Veteran has access to the services they need to adapt more easily to their transition.

Third, it was suggested that Veterans be kept in the military health care system for life or for a few years after the transition to give them time to find a general practitioner. As this participant put it, it would be simple for Veterans to continue to be treated in the military health system for their pain after their service:

Je trouve que la solution la plus facile, ce serait qu’on reste dans le système de santé militaire même si on est vétéran. Que quand qu’on sort, bien la porte se ferme pas du côté des militaires. (P2)

Although not all participants agreed with the idea of staying in the military health care system for the rest of their lives, all would have liked to have stayed in it until they found a primary care physician.

Fourth, it was suggested that it would be interesting to establish specialized chronic pain clinics for Veterans, like existing clinics that treat operational stress injuries:

Ils l’ont fait avec le PTSD. Tu as vu qu’il y a une transition du militaire au civil pour les post-traumatique … ils ont mis une priorité là-dessus et la transition militaire au civil se fait très bien. … Pourquoi ils ne font pas le même type de programme, mais pour douleur chronique? (P3)

As shown in this Veteran’s testimony, all participants agreed that chronic pain should be considered a priority in the post-transition care of Veterans and that specialized services for them outside civilian pain clinics, where wait times can be very long, would be of great help.

Finally, it was suggested that education about military culture and the realities of Veterans should be improved among the general population and health care professionals so that they are more aware of Veterans’ unique needs and realities. These recommendations, according to the participants, would have helped ease their transition and provided them with the resources they needed to continue to live rich and active lives despite the persistence of pain.

Discussion

This article aimed to describe the experiences and needs of Canadian Veterans living with chronic pain during their transition to civilian life and to explore the repercussions of their pain on different aspects of their lives. The findings of this article confirm that the transition to civilian life for medically released Veterans remains a complex life change. Difficulties in accessing civilian health care and the evaluations required to have their disabilities recognized by VAC made it difficult for participants to adjust to their new reality as Veterans. These findings are consistent with those of other studies that have emphasized that access to general practitioners and professionals who are sensitive to Veterans’ realities remains a major challenge to improving the transition.^9,10

Our results also confirm that chronic pain has major repercussions on the transition to civilian life, affecting all aspects of the participants’ lives and making it more difficult to realize their passion, maintain good relationships with their loved ones, and perform daily and domestic life activities. These findings are consistent with the existing literature, which shows that chronic pain is a condition that affects all biopsychosocial and spiritual spheres of the lives of those who experience it.^16–18 Pain’s biopsychosocial repercussions could explain, in part, why Veterans living with it experience a more difficult adjustment in MCT. Because of their limitations, it is harder for them to find ways to redefine their identity, discover a new sense of purpose, reorganize their daily life outside the strict routines of the military, and nurture new social connections.^2–4

Finally, the results of our study shed new light on the relationship between military culture and chronic pain. It has already been suggested that the minimization of pain and the culture of constant self-improvement in the CAF lead military personnel to develop chronic pain.19 However, our results show that certain institutionalized mechanisms, such as requiring soldiers to dress in parade uniform when injured to be identified as weak, reinforced the idea that pain was a weakness to be ignored. Given that approximately 64% of Veterans are reported to be living with chronic pain,9 it is important to continue to rethink these procedures to stop the development of preventable pain.

This study has its limitations. First, almost all the participants we met enlisted in the 1980s and 1990s. According to participants, major changes would have taken place after the deployments to Bosnia and Afghanistan, and the CAF would have become more understanding of military personnel’s physiological and psychological limitations. Second, almost all participants were released from the CAF between 2016 and 2021. Their perceptions and recommendations regarding the transition to civilian life do not take into account recent changes in the release process. In fact, the CAF and VAC have developed a new transition process that includes a support team for anyone undergoing a CAF release. Twenty-seven transition centres, more than half of which were already in service by 2023, will provide those services to Veterans across the country.20 Third, participants were recruited using snowball sampling. This method is known to produce a convenience sample that relies on the personal resources and contacts of the researchers. It may not be representative of the population being studied and may be biased.21 The participants recruited for this study were from similar age groups and ethnic backgrounds. Also, because of the exploratory nature of the research and the depth of data collected in each group interview, the study sample consisted of only eight participants. Future research would benefit from a more diverse and larger sample. Finally, because our data collection was conducted through focus groups, we chose not to address sexual misconduct experienced by military personnel within the CAF to respect the integrity and privacy of all participants. However, future research on this topic among Veterans, especially female Veterans, is needed. Although some research has already established a link between sexual misconduct and chronic pain among female Veterans, none seems to have explored the experiences of these individuals in a qualitative way to understand their realities and needs in depth.^11,22,23

Despite these limitations, the results of this study provide relevant information. Although participants made the transition to civilian life several years ago, many are still marked by this period of their lives. They often feel alone and without resources, and their relationship with themselves and their loved ones remains permanently affected. Therefore, it would be interesting to consider offering new resources to Veterans who transitioned several years ago to ensure they receive the support they need. In addition, despite VAC services and resources to help them, participants had significant needs to simply function on a day-to-day basis. Therefore, it would be important to take preventive measures to try to avoid situations in which service members find themselves at a physical and psychological point of no return that irreparably affects their quality of life. Better management of acute pain to prevent it from becoming chronic and ending the stigmatization of service members who need health care services through practices such as the sick parade would be ways to preserve the physical and mental integrity of military personnel.10 Finally, many participants said that they appreciated taking part in the study because it allowed them to be involved and express their experiences. More space for them to tell their stories and draw on their experiences could be beneficial in helping Veterans make sense of their new reality.

Conclusion

In conclusion, this study aimed to describe how Veterans experience their transition to civilian life in the context of chronic pain. For Veterans, this health condition poses many challenges in their transition to civilian life because it affects multiple aspects of their lives and complicates their adjustment to this new stage of life. Although significant changes have been made in the past to improve resources for Veterans living with operational stress injuries, a reform of chronic pain services is necessary to better serve this population and enable them to thrive after their military careers despite the persistence of their pain symptoms.

Biographies

Gabrielle Leblanc-Huard, MSW, is a doctoral candidate in social work at Université Laval, a 2024 Vanier Scholar, and a 2025 Pierre Elliott Trudeau Scholar. Her doctoral thesis focuses on the experience of crip time among young adults living with chronic pain during the period of transition to adulthood. Although her research interests are diverse, she primarily focuses on improving the living conditions and empowerment of people living with chronic pain.

Capt. Hélène Le Scelleur, MSW, is a doctoral candidate in social work at the University of Ottawa. Her research focuses on identity transitions and moments of crisis among Canadian military personnel who have been released after an operational stress injury. She served for 26 years in the CAF, which provides her with highly relevant lived experience.

Gabrielle Fortin, PhD, has been a social worker in oncology and palliative care since 2011. A professor in the School of Social Work and Criminology at Université Laval since 2020, her research focuses on developing psychosocial and interdisciplinary practices in health care. Her work aims to enhance the quality of life of individuals and families facing serious illness.

Appendix 1. English translations of quotes

Theme and participant no.	Translation
Theme 1: The army and pain — bodies as prematurely worn machines
P10, p. 6	When you’re in the military, you’re not allowed to have weaknesses. If you have one, you hide it, or you live with. … You want to be a real warrior.
P2, p. 6	They called it the sick parade in the morning, at 7 a.m. … It was like segregation.
P5, p. 6	You’d come in and say, “Oh, it hurts in such and such place.” … “Here, Naproxen.”
P9, p. 6	In their minds … we’re little girls, so if it’s heavy, well, the boys will carry it for us. Except that in the army, it’s one man, one kit. So you carry your kit around with you.
P2, p. 6	It’s that the machine, you push it all the time all the time until you hit the wall … we took in too much and hit the wall.
P3, p. 6	My career was going well, but when I started having a lot of appointments, it wasn’t the same game anymore.
Theme 2: The transition to civilian life — rediscovering oneself in an organizational maze
P10, p. 7	When I came out of the Forces, it was like a depression. I was in bed, eating spaghetti and listening to TV shows all day. … Everything I’d built up was behind me.
P3, p. 7	There’s the anxiety, the anxiety of leaving a family after all the years I’ve done. Friends, military, family.
P2, p. 7	You spend your whole life in a health care system that’s military, parallel to a civilian health care service. From one day to the next … the door slams shut.
P7, p. 7	It’s the twelve tasks of Asterix. You’ve got to fight. You’ve got to be stubborn, you’ve got to be on top of your game.
Theme 3: Living with chronic pain — a daily roller coaster ride
P9, p. 7	Sometimes, I can be in bed for a few days because I can’t function. Just facing that pain is exhausting, it’s burning.
P2, p. 7	Yes, it’s chronic pain, emotional and mental pain, but bereavement … it’s a roller-coaster, I would say.
P8, p. 7	Chronic pain broke up my family. … I sent my youngest daughter to her father because I was no longer able to look after her. … I don’t live with my partner anymore because it required an adjustment that he wasn’t ready to make.
P9, p. 8	You get frustrated because you say, “I’m sick of complaining and making everyone around me suffer because I’m in pain. I’m undermining the morale of everyone around me at home.
P2, p. 8	For me, the way to cope was the Stella Artois. … No matter how hard you push, no matter how hard you try, the pain is always there. … So at some point, well, the Stella … is there. It loves you. You love it. It doesn’t say a word and it makes you happy.
P 3, p. 8	You need money to compensate for your chronic pain. I’ve always wanted a cottage. … I bought the cottage. … I have zero renovations to do. … You need money to be able to do that, otherwise you fall into a void and do nothing.
P7, p. 8	Even if I have a [pain crisis], if I have to go motorcycle riding, I’d rather go riding … the well-being I’ll get from it will be greater than not being able to.
Theme 4: Recommendations for the transition to civilian life in the context of chronic pain
P8, p. 8	I think the role of peer helper is really crucial. It’s really important. Because a lot of time it’s going to be people that you’ve served with before, that have been through things, that are coping well despite everything.
P3, p. 8	I called a case management agent. I said, “I’m seeing programs that I didn’t know about when I was released.” So I took the initiative because I’m starting to understand how things work in VAC and I think it’s just a communication problem because there are so many programs available.
P2, p. 9	I think the simplest solution would be to stay in the military health care system, even if you’re a Veteran. That when you get out, the door doesn’t close on the military side.
P3, p. 9	They did it with PTSD. You’ve seen that there’s a transition from military to civilian for post-trauma … they’ve put a priority on that, and the military-to-civilian transition is going very well. … Why don’t they do the same type of program, but for chronic pain?

VAC = Veterans Affairs Canada; PTSD = posttraumatic stress disorder.

Funding Statement

This article received funding from the Chronic Pain Centre of Excellence for Canadian Veterans.