Pain Beliefs in the Military: A Qualitative Study Exploring the Perspectives of Instructors Within the Canadian Armed Forces on How Pain Is Addressed in Basic Training and the Broader Military Culture.

Background: Pain beliefs play an important role in how people understand and cope with pain, and they are especially relevant for military personnel and Veterans who bear a disproportionately high burden of chronic pain. However, limited research has examined which pain beliefs are central to military training and the broader military culture from the perspective of active basic training instructors. Aim: The current study aims to explore what beliefs about pain are emphasized in basic military training and the broader military culture from the perspective of active basic training instructors within the Canadian Armed Forces. Methods: We used a qualitative descriptive study design involving two semi-structured focus groups with instructors. The transcripts were analyzed using inductive content analysis. Results: Three themes were generated. Theme 1 describes how instructors aim to teach recruits to prioritize mission and team success by pushing through pain and distinguishing it from injury. Theme 2 outlines the culture around pain in training and the broader military. Injuries are often experienced as personal failures and threaten one's identity. Thus, there is pressure to endure painful injuries and stigma for seeking care. Theme 3 describes instructors' critical reflections on how pain is addressed within the military, emphasizing that the military's relationship with pain is a double-edged sword with both helpful and harmful aspects. Conclusions: There is a tension between the military's operational goals and the effective management of pain and injuries. Implications for military training and future research are discussed.