A woman dressed in military fatigues looks to her right, arms crossed over her chest. This stock photo reflects one of the U.S. Army veterans mentioned in the article.

A new study looked at the benefits of massage and other nonpharmacological treatments for U.S. Army service members.

It found that therapies that are traditionally referred to as complementary health care might have a positive effect on lessening rates of addiction, overdose and suicide among veterans.

Service members with chronic pain who received — including massage, exercise and other physical therapy, chiropractic, biofeedback, acupuncture, electrical modulation and others — during active duty had a significantly lower risk for long-term adverse outcomes than those who did not receive such treatments, according to recent research.

The study, “Nonpharmacological Treatment of Army Service Members with Chronic Pain is Associated with Fewer Adverse Outcomes After Transition to the Veterans Health Administration,” focused on the health records of 142,539 U.S. Army service members with chronic pain after deployment to Iraq or Afghanistan between 2008 and 2014.

Study Design

The study compared those who did and did not receive nonpharmacological treatment in the Military Health System (MHS) and analyzed their adverse outcomes after ending active duty and making the transition to the Veterans Health Administration (VHA).

According to the researchers, health records of the service members indicate the use of 13 types of nonpharmacological treatment, ranging from massage and biofeedback to acupuncture and ultrasonography.


Data from the study show close to 18% of the service members with chronic pain received massage therapy, making it the fifth most popular nonpharmacological treatment behind exercise therapy, other physical therapy, chiropractic care, and TENS and other electrical modulation.

The main outcome measure in this study was the risk of adverse outcomes after ending active duty and making the transition to the VHA. The researchers looked at four adverse outcomes, as documented in the VHA health records: “diagnoses of alcohol and/or drug disorders; poisoning with opioids, related narcotics, barbiturates or sedatives; suicide ideation; and self-inflicted injuries including suicide attempts.”

Results of the research showed a significantly lower risk for all four adverse outcomes among veterans with chronic pain who received nonpharmacological treatment during active duty as compared to those who did not.

[Read “Veterans Learn to Reconnect with Meditation, Movement & Massage.”]

NPTs Recommended

“Our results suggest that nonpharmacological treatment provided to active duty service members with chronic pain may reduce their odds of long-term adverse outcomes,” stated the study’s authors. “Given known associations of these adverse outcomes with morbidity and mortality, providing nonpharmacological treatment to service members with chronic pain could potentially save lives.”

The authors recommend further research on the effects of specific modalities and the dose in which they’re received, noting that “we did not study individual [nonpharmacological treatment] modalities,” and that “if some modalities did not protect against adverse outcomes, our results may understate the effect for [nonpharmacological treatment] modalities that did protect against adverse outcomes.”

Authors: Esther L. Meerwijk, Mary Jo Larson, Eric M. Schmidt, Rachel Sayko Adams, Mark R. Bauer, Grant A. Ritter, Chester Buckenmaier III, and Alex H.S. Harris.

Sources: VA Health Services Research & Development, Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California; Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts; Program Evaluation and Resource Center, VA Palo Alto Health Care System, Menlo Park, California; Defense and Veterans Center for Integrative Pain Management, Uniformed Services University, Rockville, Maryland; and Department of Surgery, Stanford University, Stanford, California. Originally published online in October 2019 in the Journal of General Internal Medicine.