Recent studies of the veteran population have highlighted the connection between post-traumatic stress disorder (PTSD) and chronic pain. There are different ways in which these two conditions may be linked, and understanding their relationship is critical for chronic pain treatment.
Post-traumatic stress disorder is a condition that develops when a person witnesses or undergoes a terrifying event that threatens or actualizes physical harm on himself or another. The condition often manifests among victims of abuse, rescue workers and service members. The intense fear and agitation involved in post-traumatic stress disorder can prevent the affected person from living a normal life. Symptoms include reliving the horrifying event in flashbacks and nightmares, avoiding places, people and things that remind you of the event, intensified emotions, insomnia, jumpiness, hyper-alertness and problems with interpersonal relationships, such as difficulty expressing emotion or affection.
Chronic pain can be related to PTSD in multiple ways. The event that caused PTSD may have caused physical trauma that led to chronic pain. It’s also possible that the agitation involved with PTSD causes the pain by creating chronic muscle tension. Living in constant anxiety means that the fight or flight response is always active. When the brain senses danger, it sends signals that contract the muscles. This is meant to prepare you for action, but in the case of PTSD, it just causes chronic muscle tension. Another connection between the two conditions resides in the brain. The amygdala is a part of the brain that processes both mental and emotional pain signals. An increase in emotional pain can lead to over-activity of the amygdala, which can translate physically into increased sensation of pain. This debunks the “all in your head” diminution of pain, since it speaks to the very real physical sensation of pain that is linked to emotional stimuli.
Treating chronic pain requires the treatment of post-traumatic stress disorder, then, when they coincide. An exact incidence rate for PTSD is not available, since many with PTSD likely don’t seek treatment. Still, some data exists. The Center For Deployment Psychology states that 47% of the veterans who served in Operation Iraqi Freedom and Operation Endure Freedom who sought treatment for back and neck pain also met criteria for PTSD. It is important in medical and patient communities to promote the idea that PTSD is a reaction to trauma just like infection is a reaction to harmful physical stimuli. It is a mental health issue that needs addressing just like a physical health issue. In fact, it must be addressed if you are to expect improvements in your physical health.
If you’ve experienced increased agitation and fear behaviors months after involvement in a traumatic situation, consider the possibility that you have some level of PTSD. When seeking treatment for chronic pain, be sure to take your emotional and psychological well-being into account. See www.ptsd.va.gov to find out where to get help.