PTSD: National Center for PTSD

Chronic Pain and PTSD: A Guide for Patients

What Is Chronic Pain?

Chronic pain can come from many things. Some people get chronic pain from normal wear and tear of the body or from aging. Others have chronic pain from various types of cancer, or other chronic medical illnesses. In some cases, the chronic pain may be from an injury that happened during an accident or an assault. Some chronic pain has no explanation.

How Common Is Chronic Pain?

Approximately one in three Americans suffer from some kind of chronic pain in their lifetimes, and about one quarter of them are not able to do day to day activities because of their chronic pain. Between 80% and 90% of Americans experience chronic problems in the neck or lower back.

How Do Health Care Providers Evaluate Pain?

Care providers generally assess chronic pain during a physical exam, but how much pain someone is in is hard to determine. Every person is different and perceives and experiences pain in different ways. There is often very little consistency when different doctors try to measure a patient's pain. Sometimes the care provider may not believe the patient, or might minimize the amount of pain. All of these things can be frustrating for the person in pain. Additionally, this kind of experience often makes patients feel helplessness and hopeless, which in turn increases tension and pain and makes the person more upset. Conversation between the doctor and patient is important, including sharing information about treatment options. If no progress is made, get a second opinion.

What Is the Experience of Chronic pain Like Physically?

There are many forms of chronic pain, including pain felt in: the low back (most common); the neck; the mouth, face, and jaw (TMJ); the pelvis; or the head (e.g., tension and migraine headaches). Of course, each type of condition results in different experiences of pain.

People with chronic pain are less able to function well in daily life than those who do not suffer from chronic pain. They may have trouble with things such as walking, standing, sitting, lifting light objects, doing paperwork, standing in line at a grocery store, going shopping, or working. Many patients with chronic pain cannot work because of their pain or physical limitations.

What Is the Experience of Chronic Pain Like Psychologically?

Research has shown that many patients who experience chronic pain (up to 100% of these patients) tend to also be diagnosed with depression. Because the pain and disability are always there and that may even become worse over time, many of them think suicide is the only way to end their pain and frustration. They think they have no control over their life. This frustration may also lead the person to use drugs or have unneeded surgery.

Chronic Pain and PTSD

Some people's chronic pain stems from a traumatic event, such as a physical or sexual assault, a motor vehicle accident, or some type of disaster. Under these circumstances the person may experience both chronic pain and PTSD. The person in pain may not even realize the connection between their pain and a traumatic event. Approximately 15% to 35% of patients with chronic pain also have PTSD. Only 2% of people who do not have chronic pain have PTSD. One study found that 51% of patients with chronic low back pain had PTSD symptoms. For people with chronic pain, the pain may actually serve as a reminder of the traumatic event, which will tend to make the PTSD even worse. Survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives.