Trauma and Chronic Pain

Effects of trauma

Physical (e.g., injuries, surgery), emotional, or psychological traumas can affect the physical body.

A definition of trauma I particularly like comes from SAMHSA-HRSA (Substance Abuse and Mental Health Services Administration-Health Resources and Services Administration) Center for Integrated Health Solutions:

Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being.

Please note that trauma is defined as experienced by the survivor. The same event that was traumatizing to one person may not be to another.

Studies indicate an association between chronic pain syndromes and a wide variety of surgical operations and physical trauma. Furthermore, past traumatic life events and depressed mood have been found to be predictive of chronic pain; and traumatic childhood events have been found to be significantly related to chronic pain. [See below for quotes from scientific studies, and click here for a list of resources addressing trauma and chronic pain.]

While not all chronic myofascial-pain sufferers have experienced past emotional trauma, from my personal experience and research I know that trauma can be a contributor to chronic pain. (It is also likely a contributor to other physical health problems, as well as to mental health issues.) Plus, people exposed to trauma can be affected to different degrees.

However, I have found that the general public's concept of the effects of emotional trauma focuses mainly on common post-traumatic stress disorder (PTSD) symptoms: nightmares, flashbacks, increased heart rate, sweating, and startle responses. Chronic pain or other chronic illnesses are usually not associated with the layperson's understanding of the effects of trauma.

Two excellent books on this topic are Peter Levine's Waking the Tiger: Healing from Trauma and Robert Scaer's The Body Bears the Burden: Trauma, Dissociation, and Disease, which are listed under Trauma and pain within the Resources page, along with a few other good books.

Numerous studies in the scientific literature identify an association between chronic pain and both physical and emotional trauma. Unfortunately, the medical professionals who initially treated my chronic pain either weren't aware of this or didn't mention it to me. As it turned out, past traumas were contributing to my chronic pain. I know this because it wasn't until I acknowledged and addressed those traumas—after years of trying traditional treatments—that my pain fell significantly and consistently to lower levels.

Additionally, whether or not an event traumatizes a person, often unresolved emotions surrounding the event can often affect chronic pain and illness. As for chronic pain sufferers who do have traumatic pasts, they are unlikely to be evaluated by their healthcare professionals to determine if the trauma is causing or perpetuating their pain. The result is unresolved trauma and ongoing pain. Addressing the true source of pain is what can finally begin to alleviate the pain.

What I learned firsthand is that chronic pain can be inextricably tied to trauma. But what I want to emphasize here is that this isn't my experience only. Scientific studies back this understanding. [See Trauma and pain resources.]

My experience taught me that my body held suppressed traumas. Our bodies (through our subconscious) often remember more than we allow our conscious minds to remember. In order for those past traumas to lose their hold on us, we must release them. And that is easier said than done for many of us. 

There is an entire scientific/medical field for treating trauma. But I've learned that healing begins by first acknowledging the trauma and then somehow working through it. I'll leave how to work through trauma up to the many other resources on treating trauma. [See Trauma and pain resources.] However, myofascial release bodywork is what dramatically helped me. [See JFB-MFR treatment.]

If you take nothing else from these pages, what’s most important to realize is that both physical and emotional traumas can affect our physical well-being, and we have a better chance of healing if we address them.

Healing is not easy, and in some cases it can take a long time. But continuing to release past issues helps us to begin to leave the physical and emotional pain behind.  

Recommended Reading

Click here for books and other resources that address trauma and healing.

Find out more

Quotes from Scientific Studies on Trauma and Pain


"Surgery and trauma are recognised as important causes of chronic pain, although their overall contribution has not been systematically studied. ... Trauma was a cause of pain in 18.7% of patients, and was most common in pain in the upper limb, the spine and the lower limb. Patients with chronic pain associated with trauma are on average younger than those with chronic [non-traumatic] post-surgical pain" (Crombie, Davies, and Macrae, 1998).

"Chronic pain after surgery until recently has been a neglected topic. ... A wide variety of operations have been shown to be associated with chronic pain syndromes and it is probable that, for the others, the problem also exists but has merely not been documented. Patients complain of a diverse group of symptoms and [pain] management must involve careful attention to each of the problems that the patient suffers. For the longer term, a shift in attitude is required and there is an urgent need for good quality research to try to elucidate risk factors and causes" (Macrae, 2001).

​​​"Trauma is increasingly recognized as a factor in the development of chronic pain. ... Once chronic pain has developed it is more difficult to treat." (Curran and Brandner, 2005).

"Most patients who undergo surgery recover uneventfully and resume their normal daily activities within weeks. Nevertheless, chronic postsurgical pain develops in an alarming proportion of patients. ... The transition of acute postoperative pain to chronic postsurgical pain is a complex and poorly understood developmental process, involving biological, psychological and social–environmental factors" (Katz and Seltzer, 2009).


"Chronic pain is more common following trauma than often realised. It may ... often include a neuropathic component which can be difficult to treat. ... This article aims to describe the features of chronic pain following trauma using a bio-psycho-social model. ... A multi-disciplinary team using physiotherapists and psychologists is generally required [to treat chronic pain following trauma] and the importance of good rehabilitation following major trauma cannot be over-emphasised. ... The limited role of invasive procedures is also discussed [in this paper]" (Beard and Aldington, 2012).

"Recent data show that chronic pain and PTSD are highly comorbid" (Katz and Seltzer, 2009).

​"Greater exposure to past traumatic life events and depressed mood were most predictive of chronic pain; depressed mood and negative pain beliefs were most predictive of chronic disability" (Casey et al., 2008).

"Early detection of elevated depressive symptoms and high trauma exposure may identify individuals at greater risk for developing chronic pain syndromes who may benefit from early multidisciplinary intervention" (Casey et al., 2008). ​​
"Findings are consistent with the hypothesis that [psychologically] traumatic events are associated with an increased prevalence of functional somatic syndromes" (Afari et al., 2014).

"Child traumatic events are significantly related to chronic pain" ​(Goldberg, Pachas, and Keith, 1999).

"Multiple childhood psychological traumas may predispose a person to chronic low back pain" (Schofferman, et al., 1993).

"​Childhood abuse has even been related to whether surgery for back pain is successful. ... Treatment of pain in women with a history of child or domestic abuse should include ways to help the body 'un-learn' its dysfunctional way of handling current stressors, thereby reducing their pain.
" (Kendall-Tackett, Marshall, and Ness, 2003).

"Our research suggests that the relationship between chronic pain and depression may be attributable in part to childhood abuse history" (Goldberg, 1995).

"A history of physical, sexual and verbal abuse is more likely to occur in a chronic pain group than in a control group of hospital employees. Although child abuse is reported to be as high as 25% in the general American population, the statistics for chronic pain patients are twice as high as in the general population" (Goldberg and Goldstein, 2000).

"These data suggest that a general factor associated with various forms of trauma predicts number of psychophysiological and pain disorders ..." (Sansone, et al., 2006).

"Childhood abuse was associated with more reported pain [in men and women]" (Sachs-Ericsson, Kendall-Tackett, and Hernandez, 2007). 

"Women with childhood maltreatment have a wide range of adverse physical health outcomes" (Walker, et al., 1999).

"Women who reported either child or domestic abuse were significantly more likely to report pain symptoms than women in the control group. ... These findings held true even after controlling for depression" (Kendall-Tackett, Marshall, and Ness, 2003).

"This is the first study to demonstrate that early childhood trauma predicts increasing levels of core symptoms of CFS [chronic fatigue syndrome] in the daily flow of life. Moreover, findings of this study suggest that emotional trauma may be particularly important in CFS" (Kempke et al., 2013).

"These preliminary results suggest that sexual victimization may be an important factor in the development of irritable bowel syndrome in some patients. Future studies attempting to categorize subgroups of patients with irritable bowel syndrome should inquire into past histories of sexual victimization" (Walker et al., 1993).



Text is highlighted in bold for emphasis.

This is just a sampling of quotes from available studies; the list goes on and on. Unfortunately, this information is not yet in our collective societal consciousness (including that of many practicing healthcare workers).

Full citations are given under Trauma and Pain within the Resources page.