Trauma and Chronic Pain

The Connection

Trauma and chronic pain frequently co-occur and can influence each other in complex ways. People with trauma histories are more likely to develop chronic pain, and chronic pain itself can be traumatic. Understanding this connection is important for effective treatment of both conditions.¹

What Is Trauma?

Event(s) that overwhelm ability to cope
Physical, emotional, sexual abuse
Accidents and injuries
Combat/violence exposure
Medical trauma
Neglect and abandonment
Adverse childhood experiences (ACEs)

How Trauma Affects Pain²

Sensitizes nervous system
Alters stress response systems
Increases inflammation
Affects pain processing in brain
May lead to hypervigilance to body sensations
Creates learned patterns of bracing/tension

Research Findings³

Higher rates of ACEs in chronic pain patients
PTSD common in chronic pain (up to 50%)
Shared brain pathways
Both involve central sensitization
Treatment of one may help the other

Signs Trauma May Be Involved

Pain began after traumatic event
Pain triggers emotional responses
Certain situations worsen pain
Pain in areas related to trauma
Treatments don't work as expected
Strong reactions to medical procedures

Trauma-Informed Care

Recognizes impact of trauma
Creates safety in treatment settings
Provides choice and control
Avoids retraumatization
Builds on strengths

Treatment Approaches

For Trauma

Trauma-focused therapy (EMDR, CPT)
Somatic experiencing
Trauma-sensitive yoga

For Both

Grounding techniques
Mindfulness-based approaches
Body-based therapies
Integrated treatment programs

Finding Help

Trauma-informed therapists
Pain psychologists with trauma training
EMDR-trained clinicians
Integrated pain programs

Important Notes

Having trauma doesn't mean pain isn't "real"
Pain is always physical AND psychological
Addressing trauma doesn't replace medical care
Go at your own pace
Recovery is possible

References

Sachs-Ericsson N, Kendall-Tackett K, Hernandez A. Childhood abuse, chronic pain, and depression in the National Comorbidity Survey. Child Abuse Negl. 2007;31(5):531-547.
Afari N, Ahumada SM, Wright LJ, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosom Med. 2014;76(1):2-11.
Siqveland J, Hussain A, Lindstrøm JC, et al. Prevalence of posttraumatic stress disorder in persons with chronic pain: a meta-analysis. Front Psychiatry. 2017;8:164.