Musculoskeletal Injury Prevention Across Military and Veteran Populations: The Role of Sleep, Stress, and Holistic Health

Musculoskeletal injuries (MSIs) are among the most prevalent health conditions affecting military personnel and are a leading cause of chronic pain, disability, and poor quality of life among veterans. Injuries sustained during active duty often persist after service, accelerating the development of chronic pain and disease and restricting daily activities. Evidence shows that inadequate sleep, chronic stress, and limited injury-prevention strategies significantly increase injury risk and worsen pain. In contrast, multidomain, education- and non-pharmacologic interventions that target sleep, stress regulation, and movement behaviors can improve recovery and long-term functional outcomes. This literature review explores how sleep hygiene, stress management, and injury-prevention measures influence MSI risk, recovery, and health outcomes throughout the military-to-veteran journey by improving quality of life and functional participation in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). It emphasizes that MSIs are a lifelong health issue, not just isolated injuries, and underscores the importance of integrated, prevention-focused strategies across military and veteran health systems. The review also discusses implications for clinical practice, transition programs, and veteran-centered policies, as well as directions for future research to enhance health outcomes across the service-to-civilian lifespan.