If you’ve been living with both PTSD and unexplained chronic pain, you’re not alone—and you’re not imagining the connection. Research shows that trauma doesn’t just live in our minds; it rewires our nervous system and creates very real physical pain that can persist for years. Understanding this connection between PTSD and chronic pain is the first step toward finding relief that addresses both conditions simultaneously.
When Emotional Pain Becomes Physical
Across Chicagoland, we see patients who’ve spent years seeking answers for persistent pain—migraines, fibromyalgia, back pain, nerve pain—only to discover that unresolved trauma is at the root. This isn’t coincidence. A comprehensive systematic review found strong associations between childhood trauma, PTSD, and chronic pain outcomes in adults, emphasizing the critical need for trauma-informed approaches to pain management (Rousseau et al., 2024).
The connection runs deeper than stress causing muscle tension. Trauma fundamentally changes how our brain and body process pain signals. When you experience a traumatic event, your nervous system shifts into survival mode—and sometimes, it never fully shifts back.
The Neurobiology Behind the Connection
Your brain’s alarm system includes three key players: the amygdala (your threat detector), the hippocampus (your memory processor), and the prefrontal cortex (your emotional regulator). In PTSD, these regions show measurable changes. The amygdala becomes hyperactive, constantly scanning for danger. The hippocampus struggles to file away traumatic memories properly, leading to flashbacks. The prefrontal cortex—responsible for calming you down—becomes less active.
Here’s where it gets interesting: these same brain regions are intimately involved in how we process pain. Research reveals overlapping neural circuits and neurobiological factors that contribute to both PTSD and chronic pain, including shared neuroanatomy in regions responsible for emotional processing and pain perception (Scioli-Salter et al., 2015).
Think of your nervous system as having a volume dial for pain. Trauma turns that dial up and leaves it there. Medical researchers call this “central sensitization”—your nervous system becomes hypersensitive to pain signals, amplifying sensations that wouldn’t normally register as painful.
Why PTSD and Pain Maintain Each Other
The relationship between PTSD and chronic pain isn’t one-directional—they create a cycle that reinforces both conditions. Literature reviews examining this comorbidity suggest both constitute reactive disorders with tight symptom interdependence (Brennstuhl et al., 2015). Here’s how the cycle works:
Pain triggers trauma memories. Physical sensations can act as reminders of the original trauma. A veteran with a back injury might experience pain that recalls being wounded in combat. A car accident survivor might notice neck pain triggers anxiety about the crash.
Trauma amplifies pain perception. When your brain is in constant threat-detection mode, it interprets more signals as dangerous—including pain signals. The hypervigilance that helps you stay safe from external threats also makes you hyperaware of internal sensations.
Avoidance worsens both. Many people with PTSD avoid situations, places, or activities that remind them of trauma. This same avoidance often extends to movement and physical activity, which can worsen chronic pain conditions. The less you move, the more pain you experience. The more pain you experience, the more you avoid.
Sleep disruption affects healing. PTSD commonly disrupts sleep through nightmares and hyperarousal. Poor sleep, in turn, lowers your pain threshold and impairs your body’s natural healing processes. Across Chicagoland’s busy metropolitan area, we see how the combination of trauma symptoms and chronic pain severely impacts daily functioning—from commuting to work to caring for family.
Common Pain Conditions Linked to PTSD
Research consistently identifies several chronic pain conditions that occur at higher rates in people with PTSD:
Fibromyalgia: This widespread musculoskeletal pain syndrome shows particularly strong associations with trauma history. Many fibromyalgia patients report childhood trauma or adult traumatic events preceding their symptoms.
Migraine and tension headaches: The persistent muscle tension and hyperarousal of PTSD contribute to chronic headache disorders. Many patients in our Naperville, Palos Hills, and Loves Park locations describe headaches as one of their most debilitating symptoms.
Neuropathic pain: Nerve pain conditions—burning, shooting, or electric sensations—often coexist with PTSD. The nervous system changes that occur in PTSD may make nerves more likely to send pain signals.
Musculoskeletal pain: Chronic back pain, neck pain, and joint pain frequently accompany PTSD, particularly when the trauma involved physical injury.
Gastrointestinal pain: The gut-brain connection means that trauma and stress can manifest as chronic abdominal pain, irritable bowel syndrome, or other digestive issues.
What This Means for Treatment
Understanding the PTSD-chronic pain connection changes everything about treatment. Traditional approaches often address pain and mental health separately, leading to fragmented care. A pain specialist might prescribe medications without addressing trauma. A therapist might treat PTSD without discussing physical symptoms.
At Renew Ketamine & Wellness Center, our emergency medicine physicians understand trauma from both neurological and pain management perspectives. Having treated acute trauma in emergency departments across Chicagoland, our team recognizes how psychological and physical trauma intertwine. This dual perspective informs our comprehensive approach to treatment-resistant conditions.
The most effective treatments target the shared neurobiological mechanisms underlying both PTSD and chronic pain. Results vary by individual, and not every treatment works for everyone. However, research shows that up to 70% of patients experience improvements when treatments address both the trauma response and pain processing systems simultaneously.
Three Things You Can Do This Week
- Start tracking your pain-trauma connections. Keep a simple journal noting when pain flares occur and what’s happening emotionally. You might notice patterns—pain worsening during stress, certain triggers that increase both pain and anxiety, or times when addressing emotional distress reduces physical symptoms. This awareness is the first step toward integrated healing.
- Practice grounding techniques for both pain and flashbacks. When pain or trauma symptoms spike, try the 5-4-3-2-1 technique: Identify 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste. This engages your prefrontal cortex and can help regulate both pain perception and emotional distress.
- Prioritize restorative sleep. Both PTSD and chronic pain worsen with poor sleep. Create a calm evening routine, keep your bedroom cool and dark, and consider consulting with a healthcare provider if nightmares or pain regularly disrupt your rest. Quality sleep supports the nervous system’s natural healing processes.
Moving Forward with Hope
The connection between PTSD and chronic pain is real, measurable, and treatable. You’re not weak for experiencing physical pain from psychological trauma. You’re experiencing a well-documented neurobiological response that affects millions of people.
The prominence of mental health challenges and chronic pain conditions—not just here in Chicagoland but throughout the United States—continues to grow. However, advances in neuroscience have given us unprecedented understanding of how trauma affects the body and new pathways to recovery that address both conditions simultaneously.
If you’ve been struggling with both PTSD and chronic pain, especially if traditional treatments haven’t provided relief, exploring integrated approaches that target shared neurobiological mechanisms may offer a path forward. Every person’s experience with trauma and pain is unique, and recovery timelines vary. But with the right support and evidence-based treatment, restoration of balance and reduction of suffering become possible.
References
Brennstuhl, M., Tarquinio, C., & Montel, S. (2015). Chronic pain and PTSD: Evolving views on their comorbidity. Perspectives in Psychiatric Care, 51(4), 295-304. https://onlinelibrary.wiley.com/doi/10.1111/ppc.12093
Rousseau, C., et al. (2024). Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review. PLOS One. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0309332
Scioli-Salter, E.R., Forman, D.E., Otis, J.D., Gregor, K., Valovski, I., & Rasmusson, A.M. (2015). The shared neuroanatomy and neurobiology of comorbid chronic pain and PTSD: Therapeutic implications. Clinical Journal of Pain, 31(4), 363-374. https://pmc.ncbi.nlm.nih.gov/articles/PMC4432475/
Renew Ketamine & Wellness Center offers comprehensive care for PTSD and chronic pain at our Naperville, Palos Hills, and Loves Park locations. Our team of emergency medicine physicians provides patient-focused treatment in a comfortable, clinically sound environment. Extended hours until 7 PM weeknights make care accessible for busy Chicagoland residents. To learn more about treatment options, call 630-475-1855.
