Bob* has struggled with chronic back and neck pain for years after an injury he sustained at work in his early twenties. He has tried many medical/medicinal/surgical interventions, with limited improvement. He also has a history of childhood trauma with ongoing anxiety. Is there a connection?
In my work as an Integrated Assessment Clinical Screener for DCFS, I rely heavily on the ACE 1998 study for my understanding of the effect of trauma on a person’s functioning. This study explored “adverse childhood experiences.” Specifically, the study surveyed 17,000 middle-income adults who had health data stretching back to their early childhoods. The ACE research indicated that the more adversities an individual experienced as a child — whether poverty, parental death or incarceration, neighborhood violence, or abuse — the more likely that person would suffer from serious physiological disorders as an adult.
So how does childhood trauma affect pain? First, it’s important to understand the difference between acute and chronic pain. Acute pain is felt when damage is being done to the body i.e. Bob’s injury from his early twenties. Bob is now in his thirties – why is he still feeling pain? Chronic pain, on the other hand, persists beyond the expected time and indicated point of healing, and is typically defined as longer than 3 months duration. While pain is present and may feel identical to acute pain, the experience does not have the same meaning. More recent understandings of chronic pain suggest that when pain continues in the absence of ongoing tissue damage, the nervous system itself is misfiring pain signals. Chronic pain, therefore, is best understood as a chronic disease to be managed versus an acute symptom to be cured.
You may already be familiar with the fact that emotional stress can lead to stomach aches and headaches. But you might not know that it can also cause other physical complaints and even chronic pain. One logical reason for this: Studies have found that the more anxious and stressed you are, the more tense and constricted your muscles are, causing the muscles to become fatigued and inefficient over time, which can exacerbate discomfort. Therefore, the stress of past trauma and the stress hormones that flood the body during times of arousal, exacerbate the chronic pain felt from the misfired pain signals.
In therapy, Bob discussed his past trauma and how he felt about what happened. We analyzed his feelings when his pain flared up. Then, we created a strategy to neutralize negative thoughts and feelings that intensified such episodes. Bob improved his ability cope and handle his discomfort, but more importantly his suffering lessened significantly.
*Name changed for confidentiality