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Writer's pictureAnna Olivieri

The Hidden Link: Understanding the Connection Between Stress, Trauma, and Chronic Pain

Updated: Oct 25



Chronic pain is a pervasive issue affecting millions of individuals globally, often leading to significant physical, emotional, and psychological challenges. While many people associate chronic pain with physical injuries or conditions, an increasingly recognized factor in its development and persistence is the interplay between stress, trauma, and pain perception. Understanding this connection can be crucial for effective treatment and management of chronic pain.


Stress and Its Impact on the Body

Stress is a natural response to perceived threats or challenges, activating the body's "fight or flight" response. In short bursts, stress can help us perform better in demanding situations. However, chronic stress can have detrimental effects on the body, including:

  • Increased Muscle Tension: Prolonged stress often leads to muscle tension, which can contribute to pain, particularly in areas like the neck, shoulders, and back.

  • Inflammation: Chronic stress can trigger inflammatory responses in the body, exacerbating existing pain conditions such as arthritis or fibromyalgia.

  • Altered Pain Perception: Stress affects the brain's pain processing pathways, making the brain more likely to send pain signals. This phenomenon is known as hyperalgesia, where normal sensations may be perceived as painful.

Sometimes we may not even recognize when we're living in chronic stress, when we become accustomed to "fight or flight" being our default state.


Trauma and Its Role in Chronic Pain

Trauma is anything that happens too fast, too soon, or is too much for us to handle at that time. Emotional trauma can leave imprints on an individual’s psyche and body. Traumatic experiences, such as accidents, abuse, or significant loss, can trigger chronic pain, as well as anxiety, depression, and post-traumatic stress disorder (PTSD). Even more minor traumas like feeling neglected, misunderstood, sheltered, disliked, or bullied can put people at risk of developing chronic pain.


The effect of trauma on chronic pain seems to be especially impactful when it occurs in childhood. A few examples from the research:

  • In a referral-based pelvic pain clinic, 47% reported a history of physical or sexual abuse in childhood.

  • Experiencing traumatic events in childhood (physical, emotional, or sexual) increased the likelihood of developing IBS from 2-4x (1)

  • In a study of spine surgery, among patients with the highest number of adverse childhood experiences, the surgery was unsuccessful in 85%.


The connection between trauma and chronic pain is multifaceted:

  1. Psychological Distress: People with a history of trauma often experience heightened emotional distress, which can amplify the perception of pain. The brain may interpret pain signals differently, leading to increased pain intensity.

  2. Somatic Symptoms: Trauma can manifest physically, leading to unexplained pain and symptoms anywhere in the body. This phenomenon, known as somatization, occurs when emotional distress translates into physical symptoms.

  3. Nervous System Dysregulation: Traumatic experiences can disrupt the autonomic nervous system, leading to an imbalance between the sympathetic (fight or flight) and parasympathetic (rest and digest) systems. This dysregulation can contribute to chronic pain conditions, as the body remains in a heightened state of alertness, perpetuating tension and discomfort.


The Cycle of Stress and Chronic Pain

The relationship between stress and chronic pain is often cyclical. Stress can exacerbate pain as mentioned above, while ongoing pain leads to increased stress levels, creating a vicious cycle that intensifies suffering. For many, this can feel overwhelming and inescapable.


As the stress-pain cycle spirals, lifestyle changes, such as reduced physical activity, can further exacerbate stress and anxiety. People may also resort to unhealthy coping mechanisms, such as substance abuse, as a way to manage their pain and emotional distress, further complicating their situation.


Breaking the Cycle: Strategies for Healing

Addressing the connection between stress, trauma, and chronic pain is essential for effective management. Here are several strategies that can help individuals break this cycle:


  • Create a Stress Inventory

    • Write down all the major stressors from your life that you can think of on a timeline, from childhood to the present day. If you're having trouble, think of any event that would make you sad or angry if someone you loved had to go through the same thing. Also keep in mind that even exciting things can be stressful like having a baby, getting married, moving, or starting a new job.

    • Next, add to your timeline when your symptoms first came on and the times they got worse or better.

    • Finally, review your timeline. Do you notice any correlation between stress and your symptoms? This exercise can sometimes bring some new insights. Even stress early in life can also show up as symptoms in adulthood.


  • Learn About the Pain/Stress Link: Understanding how pain can be caused and perpetuated by stress can aid healing. A few books that I recommend are listed below, but please be warned that the first two include stories of abuse including childhood abuse.

    • They Can't Find Anything Wrong! By Dr. David Clarke

    • The Body Keeps the Score by Bessel van der Kolk

    • The Mindbody Prescription by Dr. John Sarno


  • Therapeutic Interventions: Emotional Awareness & Expression therapy, trauma-focused therapy, and/or Pain Reprocessing Therapy can help individuals address the psychological aspects of their pain and trauma. Make sure you are working with a practitioner who understands neuroplastic pain and evidence-based treatments.


  • Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, and deep breathing exercises can help reduce stress and promote relaxation, alleviating tension and pain.


  • Physical Activity: Regular, gentle exercise can improve physical well-being and release endorphins, which act as natural pain relievers. Activities like walking, swimming, or tai chi can be particularly beneficial. Continuing physical activity can also help show the brain that there is no underlying physical threat.


  • Support Systems: Building a strong support network of friends, family, or support groups can provide emotional relief and understanding, helping individuals feel less isolated in their struggles.


By addressing both the emotional and physical aspects of pain, you can work toward breaking the cycle of suffering and reclaiming your lives. If you or someone you know is struggling with chronic pain, exploring these connections can open the door to new avenues of understanding and relief.


Sources:

  1. Bradford K, Shih W, Videlock EJ, Presson AP, Naliboff BD, Mayer EA, Chang L. Association between early adverse life events and irritable bowel syndrome. Clin Gastroenterol Hepatol. 2012 Apr;10(4):385-90.e1-3. doi: 10.1016/j.cgh.2011.12.018. Epub 2011 Dec 16. PMID: 22178460; PMCID: PMC3311761.

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