PTSD is often accompanied by chronic pain. It stems from the physiological and psychological impacts of trauma and stress.

The link between post-traumatic stress disorder (PTSD) and chronic pain is significant and complex. Both oftentimes intensify the other.

Comprehensive care that considers both the physical and psychological aspects of these conditions is essential for enhancing the overall quality of life for anyone coping with these conditions.

People with PTSD often experience physical symptoms — including chronic pain — which can result from the physiological and psychological effects of trauma and stress.

How common is PTSD among people with chronic pain?

The prevalence of PTSD diagnoses in people with chronic pain varies widely. A meta-analysis of 21 studies found that PTSD among people with chronic pain varies between 0% to 57%, with an average of 9.7%.

According to the U.S. Department of Veterans Affairs, however, approximately 15% to 35% of people with chronic pain also have PTSD. Thus, the exact percentage is unclear.

Research also reports that it’s more common in clinical groups (11.7%) and especially high in those with widespread pain (20.5%). But it’s less common in non-clinical settings (5.1%).

How it’s measured, however, affects the results — self-reports show a higher prevalence (20.4%) than clinical interviews (4.5%). There’s also a lot of variability between studies, so more research is needed to understand the link between PTSD and chronic pain.

Living with PTSD can significantly worsen chronic pain. People with both conditions often experience increased pain intensity as well as psychological distress, such as anxiety and depression.

PTSD may also make chronic pain more challenging to manage, possibly due to these psychological factors. PTSD can even affect how people perceive and respond to pain, which can further complicate their pain experience.

A 2018 study explored the relationship between PTSD and chronic spinal pain following accidents. Participants with comorbid PTSD experienced more intense pain and psychological distress, with decreased warmth detection thresholds and tolerance.

The researchers also found that when people with both PTSD and chronic pain feel more pain, it’s often because they tend to catastrophize about their pain (i.e., think it’s much worse than it is) and become afraid of moving.

This supports the idea that these factors contribute to the cycle of pain and fear for people with both conditions.

Another 2018 study found that people with chronic pain and post-traumatic stress symptoms (PTSS) had more severe pain, greater pain-related disability, and higher levels of depression and anxiety compared with those without PTSS.

PTSS also influenced how pain was connected to other emotional and social factors in people with chronic pain. This suggests that PTSS can make the relationship between pain and a person’s feelings and social life more complicated or stronger.

What’s the relationship between PTSD and pain thresholds?

The relationship between PTSD and pain perception is complex and may vary depending on the nature of the traumatic event.

A 2020 research review found no significant differences in pain perception between people with and without PTSD.

However, variations did emerge when looking at specific trauma types. People with combat-related PTSD tended to have increased pain thresholds, while those with accident-related PTSD had decreased pain thresholds.

Common physical symptoms associated with PTSD can include:

  • Muscle tension: Many people with PTSD have muscle tension, leading to muscle pain or aches.
  • Pain and sensory changes: Some people experience heightened sensitivity to pain or reduced pain perception, as well as numbness or tingling.
  • Headaches: Frequent tension headaches or migraine attacks are common.
  • Gastrointestinal issues: PTSD can lead to digestive problems, such as irritable bowel syndrome (IBS).
  • Cardiovascular symptoms: Increased heart rate, high blood pressure, and heart palpitations can occur.
  • Dizziness and fainting: Some people may experience dizziness, fainting, or a sense of lightheadedness.
  • Respiratory problems: Hyperventilation and shortness of breath have been linked to PTSD.
  • Skin issues: Rashes, hives, or eczema can develop or worsen.
  • Compromised immune function: PTSD may weaken the immune system, making people more susceptible to illnesses.

Several treatment options are available to help you manage PTSD:

The relationship between PTSD and chronic pain is complex. While research does suggest there’s a clear association between them, the prevalence of PTSD in people with chronic pain varies widely.

Understanding the connection between these conditions is crucial for effective care.

Whether you live with chronic pain, PTSD, or both, treating both the physical and emotional aspects is key for managing symptoms and improving your overall quality of life.