Veterans and Headaches

According to the 2018 census, there are about 16 million veterans living in the United States. Military veterans are a unique population with higher rates of certain diseases than the general population – including PTSD and traumatic brain injuries. Some of these diseases can be closely linked to headaches and migraine disease. Veterans may benefit from the same migraine treatments as civilians, as well as holistic approaches to headache care as they re-enter civilian life. 

Unique Challenges

Studies have found that veterans living with headache disorders are more likely to have other pain and sleep disorders, traumatic brain injuries (TBI), and a diagnosis of PTSD. Among female veterans, there was also an association of headache with military sexual trauma. Sometimes, headaches do not start right after the trauma, but can happen weeks to months later. Risk of headache can also happen due to airborne hazards and burn pit exposure.

The rate of headache after TBI is about 90%, and it has been estimated that up to 53% of patients will go on to develop persistent headache. Traumatic brain injury does not always mean a direct blow to the head – it can even happen after exposure to a blast. One study found that about 36% of veterans who were deployed to Iraq for one year screened positive for migraine. These veterans were more likely to make sick calls to the base clinic/hospital. Headaches were found to continue after their return home. Other studies have also shown that those who were in combat had higher rates of new onset headaches than those who did not deploy to combat.

Treatment Options

It has been felt that migraine is often underdiagnosed in the veteran population. Veterans may face stigma, like many others living with migraine, which can make getting treatment difficult. 

About 75% of veterans receive their headache care from their primary care provider. There are many options for treatment within the Veteran’s Health Administration, including a referral to neurology, prescription of a neuromodulation device, and referrals to specialties such as pain psychology, physical therapy, Whole Health (a multidisciplinary department including acupuncture, massage therapy, and tai chi among others), and polytrauma clinics.

Another option veterans may ask about is a referral to a VA Headache Center of Excellence. There are currently 28 centers across the country, and their goal is to provide access to a headache medicine specialist and multidisciplinary headache care. These clinics may also participate in telehealth care. 

Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our Editorial Board members.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.

 

Resources:   Theeler BJ, Mercer R, Erickson JC. Prevalence and impact of migraine among US Army soldiers deployed in support of Operation Iraqi Freedom. Headache. 2008 Jun;48(6):876-82. doi: 10.1111/j.1526-4610.2008.01159.x. PMID: 18549370.

Jankosky CJ, Hooper TI, Granado NS, Scher A, Gackstetter GD, Boyko EJ, Smith TC; Millennium Cohort Study Team. Headache disorders in the millennium cohort: epidemiology and relations with combat deployment. Headache. 2011 Jul-Aug;51(7):1098-111. doi: 10.1111/j.1526-4610.2011.01914.x. Epub 2011 Jun 15. PMID: 21675968.

Seng EK, Fenton BT, Wang K, Lipton RB, Ney J, Damush T, Grinberg AS, Skanderson M, Sico JJ. Frequency, Demographics, Comorbidities, and Health Care Utilization by Veterans With Migraine: A VA Nationwide Cohort Study. Neurology. 2022 Oct 31;99(18):e1979-e1992. doi: 10.1212/WNL.0000000000200888. PMID: 36100439; PMCID: PMC9651466.

Sico JJ, Seng EK, Wang K, Skanderson M, Schindler EAD, Ney JP, Lorenze N, Kimber A, Lindsey H, Grinberg AS, Kuruvilla D, Higgins DS, Graham G, Sandbrink F, Scholten J, Shapiro RE, Lipton RB, Fenton BT. Characteristics and Gender Differences of Headache in the Veterans Health Administration: A National Cohort Study, Fiscal Year 2008-2019. Neurology. 2022 Oct 31;99(18):e1993-e2005. doi: 10.1212/WNL.0000000000200905. PMID: 36100437; PMCID: PMC9651459.

Kornblith ES, Yaffe K, Langa KM, Gardner RC. Prevalence of Lifetime History of Traumatic Brain Injury among Older Male Veterans Compared with Civilians: A Nationally Representative Study. J Neurotrauma. 2020 Dec 15;37(24):2680-2685. doi: 10.1089/neu.2020.7062. Epub 2020 Aug 26. PMID: 32762279; PMCID: PMC7869884.

https://www.ptsd.va.gov/understand/common/common_veterans.asp#:~:text=PTSD%20is%20slightly%20more%20common,have%20PTSD%20in%20their%20lifetime.