Chronic pain is often treated as a physical problem. Trauma is often treated as an emotional one. But for many people, these two experiences are deeply connected.
When trauma goes unaddressed, it can shape how the body experiences pain. When chronic pain persists, it can reinforce emotional distress and trauma responses. Treating one without the other often leads to frustration, setbacks, and incomplete healing.
Understanding the connection between trauma and chronic pain helps explain why effective treatment must address both-together.
Understanding Chronic Pain
Chronic pain is pain that lasts longer than three months and continues beyond the expected healing time. It may be constant or come in waves, and it often interferes with daily life.
Common forms of chronic pain include:
- Back and neck pain
- Fibromyalgia
- Migraines
- Joint or nerve pain
- Pain after injury or surgery
According to the Centers for Disease Control and Prevention (CDC), about 20% of adults in the U.S. live with chronic pain, and nearly 7% experience high-impact chronic pain that limits daily functioning.
Chronic pain is not just a physical sensation. It affects mood, sleep, relationships, and emotional health.
What Is Trauma?
Trauma occurs when an experience overwhelms a person’s ability to cope. It can come from a single event or from repeated stress over time.
Trauma may include:
- Childhood abuse or neglect
- Domestic violence
- Sexual assault
- Medical trauma
- Military combat
- Serious accidents or loss
Trauma does not always lead to post-traumatic stress disorder (PTSD), but it can still leave lasting effects on the nervous system and body.
According to the National Council for Mental Wellbeing, nearly 70% of adults in the U.S. have experienced at least one traumatic event in their lifetime.
How Trauma Affects the Body
Trauma changes how the nervous system responds to stress. Instead of returning to a calm baseline after danger passes, the body may remain in a state of alert.
This can lead to:
- Muscle tension
- Increased inflammation
- Heightened pain sensitivity
- Fatigue and sleep problems
- Difficulty relaxing
Over time, the nervous system becomes more reactive. Pain signals may become louder, last longer, and feel more intense.
This is one reason pain can persist even when medical tests show no clear cause.
The Strong Link Between Trauma and Chronic Pain
Research consistently shows a strong connection between trauma and chronic pain.
According to the CDC’s Adverse Childhood Experiences (ACEs) study, individuals with higher ACE scores are significantly more likely to experience chronic pain in adulthood. They are also more likely to struggle with mental health conditions and substance use disorders.
Trauma can:
- Lower pain tolerance
- Increase muscle guarding and tension
- Disrupt the brain’s pain-regulation system
- Make stress-related pain flare-ups more frequent
This does not mean pain is imagined. It means the body has learned to protect itself by staying on high alert.
Why Chronic Pain Can Reinforce Trauma
The connection works both ways.
Living with ongoing pain can:
- Increase feelings of helplessness
- Trigger anxiety or depression
- Disrupt sleep and emotional regulation
- Remind people of past injuries or trauma
For trauma survivors, pain can feel unsafe or threatening, even when it is not life-threatening. This can keep the nervous system locked in survival mode.
Over time, pain and trauma can reinforce each other in a cycle that feels hard to break.
Why Treating Pain Alone Often Fails
Many chronic pain treatments focus only on physical symptoms. While this approach may help in the short term, it often misses the full picture.
Pain-only treatment may:
- Ignore nervous system dysregulation
- Over-rely on medication
- Fail to address emotional triggers
- Lead to frustration when pain persists
According to the National Institute of Neurological Disorders and Stroke (NINDS), chronic pain involves changes in how the brain processes pain-not just injury or tissue damage.
Without addressing trauma and stress, pain often continues.
The Role of Medication-and Its Limits
Medication can be helpful for some people, especially during acute pain. But long-term reliance has risks.
According to the National Institute on Drug Abuse (NIDA):
- Long-term opioid use can increase pain sensitivity
- People with trauma histories are at higher risk of dependence
- Medication alone does not address emotional or nervous system factors
When trauma is present, medication may dull symptoms without resolving the underlying cause.
Why Integrated, Trauma-Informed Treatment Matters
Integrated care treats chronic pain and trauma together, recognizing how deeply they interact.
Trauma-informed pain treatment focuses on:
- Emotional and physical safety
- Nervous system regulation
- Whole-person healing
- Choice and empowerment
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), integrated, trauma-informed care leads to better outcomes and improved quality of life for people with chronic pain and co-occurring conditions.
Evidence-Based Approaches That Address Both Pain and Trauma
Trauma-Informed Therapy
This approach helps people understand how stress and past experiences affect pain. Therapy moves at a safe pace and emphasizes emotional regulation.
As the nervous system calms, pain often becomes more manageable.
Cognitive Behavioral Therapy (CBT) for Pain
CBT helps people identify how thoughts, emotions, and behaviors influence pain perception.
The American Psychological Association (APA) recognizes CBT as one of the most effective non-pharmacological treatments for chronic pain.
Mindfulness and Nervous System Regulation
Mindfulness-based practices help retrain the brain’s response to pain.
A review in JAMA Internal Medicine found that mindfulness-based interventions significantly reduce chronic pain severity and improve daily functioning.
Gentle Movement and Body-Based Therapies
Movement helps restore trust in the body and reduce pain over time. Practices such as yoga, stretching, and physical therapy support both emotional and physical healing.
Treating Trauma and Pain Together Supports Long-Term Healing
When trauma and chronic pain are treated together:
- Pain flare-ups become less intense
- Emotional resilience improves
- Reliance on medication often decreases
- Quality of life increases
According to SAMHSA, integrated treatment reduces relapse risk and supports sustainable recovery for people with complex conditions.
A More Compassionate Way Forward
Chronic pain is real. Trauma is real. Neither should be treated in isolation.
When care addresses both the body and the nervous system, healing becomes more complete-and more humane.
People are not broken. Their systems adapted to survive. With the right support, they can learn to feel safe, regulated, and functional again.
Sources
- Centers for Disease Control and Prevention (CDC) – Chronic Pain
https://www.cdc.gov/chronicpain - Centers for Disease Control and Prevention (CDC) – Adverse Childhood Experiences (ACEs)
https://www.cdc.gov/violenceprevention/aces - Substance Abuse and Mental Health Services Administration (SAMHSA) – Trauma-Informed Care
https://www.samhsa.gov/trauma-informed-care - National Institute on Drug Abuse (NIDA) – Trauma and Health
https://nida.nih.gov/research-topics/trauma-ptsd - American Psychological Association (APA) – Chronic Pain Treatment
https://www.apa.org/monitor/2012/07-08/pain - JAMA Internal Medicine – Mindfulness and Chronic Pain
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2211346
