The Link Between Chronic Pain and PTSD
There are many people living with chronic pain throughout the UK and the impact on their lives can be profound. From being unable to work anymore to finding everyday tasks too challenging, struggling with the difficulty of the condition to the fear of not knowing why it’s happening, feeling like they can’t cope anymore to the judgement of those around them, there are many reasons why chronic pain can have an impact upon mental health.
However, it seems ‘chronic pain’ and ‘mental health’ are inextricably linked. Research has shown that one of the most common physical problems reported by those with PTSD and C-PTSD is ‘pain’. It doesn’t matter what type of traumatic event they have experienced, from physical assault to car accident, combat injury to natural disaster, people who suffer from post-traumatic stress disorder are also more likely to report a pain-related disability. For people with chronic pain, the pain may actually serve as a reminder of the traumatic event, which will tend to make the PTSD even worse. Survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives.
Chronic pain can be defined as ‘when a person suffers from pain in a particular area of the body (for example, in the back or the neck) for at least three to six months. It may be as bad as, or even worse than, short-term pain, but it can feel like more of a problem because it lasts a longer time. Chronic pain lasts beyond the normal amount of time that an injury takes to heal.’
PTSD and chronic pain
The two sitting together is a challenging combination. Research found that those experiencing chronic pain and Post Traumatic Stress Disorder (PTSD) were reporting more severe pain and a poorer quality of life that those who only experienced chronic pain. They were also showing more symptoms of depression and were more likely to be diagnosed with an alcohol or substance abuse disorder.
One particular study that looked at volunteer firefighters living with PTSD found that around 50% were struggling with pain – largely back pain – in comparison with only around 20% of firefighters who didn’t have PTSD. Further research has found that between 20% to 30% of patients with PTSD also had frequent and chronic pain symptoms.
To flip it round, you could also say that many people who have chronic pain problems are also experiencing post-traumatic stress disorder. So why do they seem to go so perfectly hand-in-hand?
Why does PTSD cause physical pain?
There are several reasons for this. Firstly, some symptoms of PTSD and C-PTSD can cause pain; for example, hyperarousal symptoms (feeling on edge, scared of your surroundings and ‘on guard’) can often lead to tense muscle pain that can in turn become chronic. This anxiety and hypervigilance that often comes with PTSD can increase the tension you put on your muscles and joints in general. One PTSD suffer commented, ‘I’d wake up in the morning and my wrists and ankles would be agony – I’d been sleeping in such a tight, wound-up position what my joints just couldn’t keep up’.
Prolonged deranged cortisol levels from PTSD can also deplete your adrenal glands, which in turn, raises the level of prolactin and therefore your sensitivity to pain increases.
Further to this, many people suffering from PTSD find they are unable to exercise as much as they’d like. This lack of movement can often lead to muscle and body pains, which can become chronic.
Additionally, many traumatic events can, of course, cause serious physical injuries which then leads to chronic pain.
Treating PTSD and chronic pain
For those suffering from PTSD and chronic pain, seeking out treatment for both issues can make a big difference to the way that you feel. Looking to treat one but not the other can be counterproductive, and therefore it’s best to see the two as a mutually-related problem. Explaining this to a doctor can help to speed up your diagnosis and any associated support.
NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT). Be sure to work with a professional to find the best methods for you.
- CHRONIC PAIN AND POSTTRAUMATICSTRESS DISORDER: MUTUALMAINTENANCE?,
Timothy J. Sharp& Allison G. Harvey, Clinical Psychology Review, Vol. 21, No. 6, pp. 857–877, 2001
- Morasco, B. J., Lovejoy, T. I., Lu, M., Turk, D. C., Lewis, L., & Dobscha, S. K. (2013). The relationship between PTSD and chronic pain: mediating role of coping strategies and depression. Pain, 154(4), 609–616. https://doi.org/10.1016/j.pain.2013.01.001
The Relationship between PTSD and Chronic Pain: Mediating Role of Coping Strategies and DepressionMorasco, B. J., Lovejoy, T. I., Lu, M., Turk, D. C., Lewis, L., & Dobscha, S. K. (2013). The relationship between PTSD and chronic pain: mediating role of coping strategies and depression. Pain, 154(4), 609–616. https://doi.org/10.1016/j.pain.2013.01.001
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It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.