Trauma & Chronic Pain: Is There A Link?

First off, I know that this can be a sensitive and challenging topic for many, so please give yourself grace as you read. Take breaks as needed, skip parts that are too overwhelming, and remember that you can always stop and come back later. 

Also, note that I am not a mental health care professional. These are the thoughts of a physiotherapist, with trauma training, and a human with lived experience of trauma. As a physiotherapist working with people living with chronic pain, it’s important to me to look at the different things and experiences that can be contributing to pain. As a human, it’s important to me to look at my pain, and my experience living with migraine, and note how my past life experiences could be contributing to my current one. 

Trauma can be a bit of a buzzword nowadays. Thankfully, in recent years, there has been less stigma around mental health (although more work can be done on this). Due to an increase in discussion around trauma and mental health in both daily life and social media, people are more willing to discuss and look at the way their past trauma and even intergenerational trauma is contributing to their lived experience, including chronic pain. 

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), trauma is defined as when a person is exposed “to actual or threatened death, serious injury, or sexual violence”. What strikes me about this definition is that trauma can arise by actually being exposed to an event or being threatened by an event. In the latter case, one does not have to experience the event itself, but the threat of the event in general can cause trauma. As well, living through these events can impact everyone differently. One person may experience the same event as another and have a completely different reaction. One person can be traumatized developing PTSD (post-traumatic stress disorder), and another can not be impacted in the slightest. 

The American Psychiatric Association defines PTSD as a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event, series of events, or set of circumstances. An individual may experience this as emotionally or physically harmful or life-threatening and may affect mental, physical, social, and/or spiritual well-being. People with PTSD have intense thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear, or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.

So..is there a link between trauma and chronic pain? Let’s get into it. 

It’s been shown that people who experience trauma are more likely to experience chronic pain. Post-traumatic stress disorder (PTSD) frequently occurs with chronic pain and both conditions can exacerbate the other. Research has also shown that childhood physical, sexual, or emotional abuse, or neglect, (adverse childhood experiences) increases the risk of chronic pain in adulthood. 

Why does trauma impact pain? More research needs to be done, but some research shows that adverse childhood experiences can cause changes in the brain contributing to increased pain sensitivity. PTSD impacts the nervous system and stress response often leaving the brain and body in a state of hyperarousal, such as the fight/flight response. This heightened response can contribute to the levels of pain you experience. 

As a physiotherapist, if someone discloses a history of trauma I will discuss the link between pain and trauma if the person is open to it. I will also refer the person to other healthcare providers such as a psychologist, counselor, social worker, or occupational therapist when appropriate. 

This relationship between pain and trauma is one of the reasons trauma-informed care is so important to me. Regardless of whether someone discloses a history of trauma to me or not, I want to ensure that I am doing my best to not retraumatize anyone and give people agency over their body and their treatment. This topic is one I am very interested in and is near and dear to my heart.

If you have experienced trauma and you notice it impacts your physical body, whether this is through chronic pain, tension, or not feeling safe in your body; my trauma-informed YouTube channel may be of interest to you. The channel offers trauma-informed practices, primarily yoga, with a few other movement and meditation practices sprinkled in. 

Visit my trauma-informed YouTube channel 

If you are someone who has experienced trauma, please know you are not alone. I hope you have support, and are finding healing. I am rooting for you.