Coping with chronic pain is a difficult struggle that requires a lifestyle management approach focused on caring for both the body and the mind. This struggle can be even more difficult when the cause of the pain involves a trauma, such as a motor vehicle accident, work-related injury, combat-related injury, assault or even complications from a surgical procedure. In some cases, a person who is exposed to a traumatic event can develop an intense fear response to the trauma — a psychological syndrome called post-traumatic stress disorder (PTSD).
Given the high rates of co-morbidity between chronic pain and PTSD, and evidence suggesting that these two disorders interact in some way, efforts to develop more effective treatments for this population are greatly needed.
It is important to recognize that certain types of chronic pain are more common in individuals who have experienced specific traumas. For example, adult survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives. The most common forms of chronic pain for survivors of these kinds of trauma involve: pain in the pelvis, lower back, face, and bladder; fibromyalgia; interstitial cystitis; and non-remitting whiplash syndromes.
The prevalence of PTSD has been estimated to be between 20 to 34 percent in patients referred for the treatment of pain. The prevalence of pain has been estimated to be between 45 to 87 percent in patients referred for the treatment of PTSD. Data obtained from VA Boston Psychology Pain Management indicate that 50 percent of patients assessed met criteria for PTSD based on PTSD Checklist scores.
Patients with co-morbid pain and PTSD experience more intense pain, more emotional distress, higher levels of life interference, and greater disability than pain patients without PTSD. Due to the interaction of these conditions, these patients can also be more complex and challenging to treat.
Some of the theories as to why this relationship occurs relate to personality development, neurobiology or neurophysiology, memory, behavior, and personal coping styles. If you have a history of any type of trauma it is essential that healthcare providers have accurate information about your experiences.
Symptoms of PTSD
With PTSD, a person is exposed to a traumatic event that involves experiencing or witnessing an actual or threat of death or serious injury.
Secondly, the person may begin to re-experience the event with reoccurring dreams and/or intrusive thoughts or “flashbacks” that can be very stressful.
Thirdly, the person with PTSD may avoid thoughts, feelings, activities, people and places that remind him or her of the trauma. She or he may even avoid talking about the trauma or steer clear of the site of the accident or incident because it is too upsetting.
Fourthly, the person may have symptoms of arousal such as having difficulty falling or staying asleep, irritability and anger, difficulty concentrating, an exaggerated response to sudden loud noises or movements, and extreme watchfulness.
Individuals may begin to experience these symptoms immediately after a trauma or even months afterward (called delayed onset). Additionally, while some people who develop these symptoms recover within a few weeks or months, a number of people may continue to experience these symptoms for longer than three months and even years later (chronic PTSD).
To learn more about the role of coexisting disorders in chronic pain management, please read my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Ariticles page.
You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.
To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.
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