Chronic pain and PTSD share biological pathways in the brain — especially if the chronic pain results from a trauma like a combat injury or car crash. The two conditions feed off each other, and a person’s function is often more heavily impacted when experiencing both.
Sheila Rauch, PhD is the deputy director of the Emory Healthcare Veterans Program.
Physical pain first of all is very common in the population. It's especially common in the population of people suffering with PTSD. We do think that there are some biological pathways that are shared between PTSD and chronic pain and that people who experience trauma have that same pathway kind of light up and both of those processes can and may occur. We know for people with chronic pain about 50 percent of people with a chronic pain condition also have post-traumatic stress disorder and that's true in veterans and non-veteran populations. What's especially interesting is that even when we look at kids who have PTSD we see about 30 percent of kids with chronic pain who also meet the criteria for PTSD. So that really suggests that there may be some similar underpinnings. Part of that may be related to traumatic injuries, like someone may actually have a physical injury. When they're in a car accident, that then they develop PTSD based on that car accident. Or for veterans based on that combat exposure, they can have all kinds of physical injuries. So part of it is that, but that doesn't really explain the level, the high rates that we have of PTSD and pain. So what we find is people who are experiencing chronic pain conditions will also see that as a reminder of their trauma experiences and it can further negatively impact their function. So if someone has both of those conditions oftentimes they feed each other where they start to avoid and start to do less and less,
their function is more heavily impacted by both PTSD and chronic pain when they're occurring together.
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Sheila A.M. Rauch, PhD, ABPP, is the Deputy Director of the Emory Healthcare Veterans Program and Director of Mental Health Research and Program Evaluation at the VA Atlanta Healthcare System. Dr. Rauch has been developing programs, conducting research and providing PTSD and Anxiety Disorders treatment for over 20 years. Her research focuses on examination of mechanisms involved in the development and treatment of PTSD and improving access to effective interventions.