Living with Chronic Pain

The Relationship Between Chronic Pain and PTSD


In some cases, the relationship between chronic pain and post-traumatic stress disorder (PTSD) is obvious. For example, if an injury occurs during a traumatic event, both chronic pain and PTSD may develop as a result. In other cases, particularly when an injury is not involved, the link is less clear.

Chronic pain and the development of PTSD

If chronic pain develops as a result of a traumatic injury, the pain can trigger traumatic memories of the event, triggering PTSD symptoms. In addition, prolonged, severe, or life-changing chronic pain may cause emotional distress which can contribute to the development of PTSD, even in the absence of a specific traumatic event.

When chronic pain and PTSD are comorbid, memories that are triggered by situations or locations can increase pain levels. Reminders of a traumatic event can heighten awareness of pain, which can also increase pain levels.

PTSD and the development of chronic pain

PTSD may also trigger chronic pain. For example, studies show that individuals diagnosed with PTSD are more likely to develop a chronic pain condition, such as rheumatoid arthritis. Inflammation and immune responses may be partially to blame.

Anxiety sensitivity

Some experts believe that anxiety sensitivity (AS) plays a part in the development of both chronic pain and PTSD. AS increases an individual’s perceived sense of alarm during a traumatic event, which increases the person’s awareness of physical injury. AS is also thought to intensify emotional levels after the event, which can contribute to PTSD.


Because of the link between chronic pain and PTSD, some treatments can help with both conditions. For example, cognitive behavioral therapy (CBT) is often useful for reducing flashbacks and other PTSD symptoms, and it may also reduce levels of pain. Other treatments such as hypnosis may improve both anxiety associated with PTSD and chronic pain levels.

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