Chronic pain affects millions of people and can show up in all kinds of ways. For some people it's neck or back pain that never seems to fully go away. For others it's fibromyalgia, migraines, pelvic pain, jaw pain, nerve pain, or digestive issues like IBS.
If you've been living with chronic pain for any length of time, you've probably spent at least a few late-night Google sessions wondering: Why is this happening? Or maybe you've had imaging, tests, and appointments that left you with more questions than answers.
One piece of the puzzle that often gets overlooked is the relationship between trauma and chronic pain.
The Hidden Connection Between Trauma and Chronic Pain
Over the past few decades, researchers have repeatedly found that trauma survivors are more likely to experience chronic pain than people without a history of trauma.¹
Great, like you didn’t have enough to deal with already, right?
That doesn't mean everyone with chronic pain has PTSD. And it doesn't mean that all chronic pain is caused by trauma. But the overlap between the two is much higher than we would expect by chance alone.² ³
Which raises an important question:
Can Trauma Cause Chronic Pain?
The short answer is yes—it can.
When we experience trauma, the brain's threat-detection system becomes highly sensitized. The amygdala, which acts a bit like your brain's internal smoke detector, learns to stay alert for danger.
That's incredibly helpful when danger is actually present.
The problem is that a traumatized brain doesn't always recognize when the threat has passed. So it sets off the full smoke alarm over a slightly crispy piece of toast.
Instead of relaxing back into a baseline sense of safety after trauma, the brain continues scanning for threats and preparing for danger.⁴ And when the brain interprets minor discomforts through that lens of danger, it generates enough pain that you’d think your house was burning down.
Sometimes this is referred to as neuroplastic pain, and it’s more a reflection of the current danger level your brain perceives than it is an indicator of broken bones or tissue damage in the body.
To be clear, this is not “all in your head”. And I know you’re not doing it on purpose.
It's just that your nervous system got really, really good at protecting you.
It's Not Just "Big T" Trauma
When many people think about trauma, they imagine major events like combat, physical assault, severe accidents, or natural disasters.
Those experiences absolutely matter. But trauma isn't always one dramatic event.
Sometimes it's growing up in an environment where you never quite knew what version of a parent was coming home that day.
Sometimes it's years of criticism, emotional neglect, bullying, chronic stress, medical trauma, or constantly feeling like you had to earn safety rather than simply having it.
This is often what people are talking about when they refer to complex trauma or CPTSD.
For someone with a sensitive nervous system, a thousand small experiences of feeling unsafe can have a profound impact over time.
The common thread isn't necessarily the event itself.
It's whether your nervous system learned that the world is unpredictable and that staying on high alert is the safest option.
The Trauma → Pain Loop
Once the nervous system becomes sensitized, a self-reinforcing cycle can begin.
A trauma history can leave the nervous system stuck in a hypervigilant state. When the brain is constantly scanning for danger, anxiety naturally increases. Then a completely neutral—or only mildly uncomfortable—physical sensation appears.
Because the brain is already operating from a place of threat detection, it interprets that sensation as dangerous.
In response, the brain generates pain as a protective signal.
The pain itself then feels scary, which reinforces the belief that something is wrong and that you are not safe. The brain receives confirmation that danger is present, becomes even more vigilant, and the cycle starts all over again.
Trauma → Hypervigilance → Increased Anxiety → Sensations Feel Dangerous → Brain Generates Pain → Pain Reinforces Danger → back to Hypervigilance
The Good News: The Brain Can Learn Safety Too
Here's the hopeful part.
If the brain can learn danger, it can also learn safety.
One evidence-based treatment designed specifically for this process is Pain Reprocessing Therapy (PRT). Research has shown that PRT can help reduce—and in many cases eliminate—chronic pain by helping the brain reinterpret sensations as safe rather than threatening.⁵
If you want to learn more about Pain Reprocessing Therapy, stay tuned for the next blog that will go into detail about how PRT can help heal chronic pain caused by trauma.
Ready to Get Out of the Trauma → Pain Loop?
If you're tired of feeling stuck in the trauma → pain loop, you're not alone.
As a trauma-informed chronic pain therapist, I help clients understand the connection between trauma, anxiety, and chronic pain so they can begin rewiring their brains toward safety.
I've also walked this path myself. After years of chronic pain, I was able to fully recover using Pain Reprocessing Therapy, which I am fully trained in. That experience is a big part of why I'm so passionate about helping others find hope and healing from chronic pain through therapy and coaching.
If you’d like to see if this approach could help you, I offer free consultation calls where we can talk about your pain, your story, and how we might begin helping your nervous system feel safe again.
References
¹ Tesarz J, Gerhardt A, Leisner S, Janke S, Treede RD, Eich W. Research examining associations between trauma history and chronic pain.
² Siqveland J, Hussain A, Lindstrøm JC, Ruud T, Hauff E. Prevalence of post-traumatic stress disorder in people with chronic pain.
³ Asmundson GJG, Katz J. Understanding the co-occurrence of chronic pain and PTSD.
⁴ Sharp TJ, Harvey AG. Chronic pain and post-traumatic stress disorder: shared mechanisms and mutual maintenance.
⁵ Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain. JAMA Psychiatry. 2021.