Chronic pain and post-traumatic stress disorder (PTSD) frequently occur together, creating a cycle where each condition can worsen the other. This comorbidity is more than coincidence—research shows that people living with both chronic pain and PTSD report more severe pain, greater psychological distress, and a poorer quality of life compared to those with only one of these conditions.
How Are Chronic Pain and PTSD Connected?
- Shared Neurobiology: Both conditions involve overlapping neural pathways and physiological responses, such as increased stress hormone production and a heightened state of alertness. Trauma can lead to chronic pain as a physical manifestation of psychological stress, and persistent pain can serve as a constant reminder of trauma, intensifying PTSD symptoms.
- Bidirectional Relationship: People with chronic pain are more likely to develop PTSD, and vice versa. For example, a physical injury from a traumatic event may cause lasting pain, which then triggers or exacerbates PTSD symptoms.
Why Does PTSD Cause Physical Pain?
- Hyperarousal: PTSD symptoms like hypervigilance and anxiety often result in muscle tension, which can become chronic pain over time. Many with PTSD describe waking up in pain due to sleeping in tense, guarded positions.
- Hormonal Effects: Prolonged stress and abnormal cortisol levels can increase pain sensitivity, making physical discomfort more intense for people with PTSD.
- Lifestyle Impact: PTSD may reduce activity levels, leading to muscle weakness and increased pain. Additionally, traumatic events may cause direct physical injuries that result in chronic pain.
Prevalence and Impact
- How Common Is the Overlap? Studies estimate that 15% to 35% of people with chronic pain also have PTSD, though rates vary depending on the population and assessment methods.
- Quality of Life: Those with both conditions are at higher risk for depression, anxiety, and substance abuse, and often experience greater disability and social withdrawal.
The Vicious Cycle
- Pain and PTSD Intensify Each Other: Chronic pain can trigger traumatic memories, while PTSD can lower pain tolerance and increase pain-related fear. This cycle leads to avoidance of activities, worsening both physical and emotional symptoms.
- Emotional Processing: Avoidance behaviours in both PTSD (avoiding trauma reminders) and chronic pain (avoiding movement) can prevent recovery and reinforce symptoms.
Treatment Approaches
Effective management requires addressing both the physical and psychological aspects through restoration of movement, engagement in meaningful activities under medical guidance.
In those that do not respond to traditional approaches, new pain treatments that can assist with this process to help get you back to feeling your best include
- Stellate Ganglion Blocks (SGBs) – these work by blocking the bodies natural ‘flight or fight’ response, which is working overtime in patients with Post Traumatic Stress Disorder
- Ketamine Infusions – these alone, have been shown to help with widespread body pain often associated with Post Traumatic Stress Disorder Symptoms
- Ketamine Assisted Psychotherapy (KAP) – this novel treatment, helps to overcome the heightened ‘flight or fight’ response associated with Flashbacks to allow the brain to process trauma in a more gentle way. This is a specialised service offered through our partner clinic AKAP.