VA pain management: 'My pain is barely a comma now'

The VA has shared a detailed success story from its Cheyenne VA Health Care System that illustrates how comprehensive pain management programs are helping veterans regain control of their lives. Former Army officer Dominic Sansone, who medically retired in 2016 after combat injuries in Afghanistan, describes his experience with the facility's pain management team as transformative, saying his pain has gone from being "the period at the end of the sentence" to "barely a comma."

Chronic pain affects millions of veterans, often stemming from service-connected injuries, repetitive stress, or combat trauma. Traditional pain management has historically focused on medications and procedures targeting the painful area itself, but many VA facilities now employ interdisciplinary teams that address pain's impact on sleep, movement, mood, nutrition, and daily functioning. The Cheyenne program, led by Dr. Karen Jiles, exemplifies this whole-health approach by bringing together multiple providers who collaborate in real time to create individualized treatment plans with each veteran rather than simply prescribing a standard protocol.

This approach is available to veterans enrolled in VA health care who receive a referral from their primary care provider. Sansone and his wife, both disabled combat veterans, had previously stopped using VA services after years of unsuccessful treatments, including multiple spinal procedures. After relocating to Cheyenne in 2024, they decided to give VA care another chance and both enrolled in the pain management program at the local facility.

The key difference Sansone noticed was the comprehensive evaluation process and the collaborative nature of care. When asked about his pain management goals, he initially wanted to accomplish something specific: standing at the mirror to shave without stopping due to back pain. What he discovered was that the question itself was designed to help him think differently about pain management. The team addressed not just his physical symptoms but also helped him mentally adjust to living with chronic pain, providing tools to accept and mitigate its impact rather than promising to eliminate it entirely. Sansone credits this shift in perspective with improving not only his quality of life but also his relationship with his wife, noting they now communicate openly instead of retreating into devices to distract from pain.

The success of this approach has practical implications for disabled veterans struggling with chronic pain who may have lost hope after unsuccessful treatments elsewhere. Sansone's experience demonstrates that pain management is not solely about reducing pain intensity but about reclaiming the activities, relationships, and goals that pain has disrupted. He has since been accepted into a master's program in social work and plans to work with veterans professionally, a goal that seemed impossible when pain dominated his daily life.

Veterans interested in accessing pain management services should start by discussing a referral with their VA primary care provider. Those already enrolled in VA health care can also request information through secure messaging on My HealtheVet or the VA Health and Benefits mobile app. While the specific structure of pain management programs varies by facility, the interdisciplinary model described at Cheyenne reflects broader VA efforts to move beyond medication-only approaches and address the full spectrum of how chronic pain affects veterans' lives.

The story underscores an important reality for disabled veterans: effective pain management may not mean living pain-free, but rather developing the mental tools and support systems to prevent pain from controlling every aspect of life. For veterans who have tried traditional pain treatments without success, asking about comprehensive pain management programs that address psychological and lifestyle factors alongside physical symptoms may open new possibilities for improvement.