Chronic pain and trauma: what the research says, and what it means for you

If you live with chronic pain, you've probably been told at some point, directly or indirectly, that it's in your head. Maybe not in those words. Maybe it was a doctor who couldn't find anything wrong, or a treatment that helped for a while and then stopped, or a quiet feeling that you were somehow choosing this.

You weren't. But the relationship between chronic pain and the mind and body is real, it's complicated, and it's not about imagining your symptoms away. It's about something much more interesting.

What the research actually shows

The connection between trauma and chronic pain is well-documented. Studies consistently show that people with a history of trauma, including adverse childhood experiences, PTSD, and prolonged stress, are significantly more likely to develop chronic pain conditions.

This isn't because trauma causes people to make up symptoms. It's because trauma changes the nervous system. Chronic threat, whether from a single overwhelming event or years of ongoing stress, keeps the body in a state of hyperarousal. The alarm system stays on. And when the alarm system stays on long enough, the body starts to hurt.

Research from the ACE (Adverse Childhood Experiences) studies, pioneered by Dr. Vincent Felitti and Dr. Robert Anda, found a strong dose-response relationship between childhood trauma and adult physical health outcomes, including chronic pain, autoimmune conditions, and fatigue disorders. The more adverse experiences, the higher the risk.

The nervous system's role

The body's pain system is not a simple alarm that goes off when something is damaged and stops when the damage heals. Pain is a protective signal produced by the brain, and it's heavily influenced by context, including the brain's assessment of threat.

When the nervous system has been conditioned to expect danger, through trauma, chronic stress, or early experiences of being unsafe, it becomes more sensitive. The threshold for pain goes down. Signals that wouldn't register as painful in a regulated nervous system get amplified.

This is not a malfunction. It's the body doing exactly what it evolved to do: protecting itself based on past experience. The problem is that past experience isn't always a reliable guide to present reality.

What somatic therapy offers

Somatic therapy works directly with the body's experience, rather than treating it as separate from the psychological. In the context of chronic pain and trauma, this matters because the patterns that contribute to pain, the bracing, the holding, the chronic tension, live in the body, not just in thought.

In practice, this might mean learning to notice and tolerate body sensations without immediately trying to fix or escape them. It might mean working with breath, movement, or posture to gently shift chronic patterns of tension. It might mean using approaches like EMDR or Brainspotting to process the underlying trauma that's keeping the nervous system stuck.

This isn't about curing chronic pain through positive thinking. It's about giving the nervous system enough safety and support to begin to regulate, and seeing what changes when it does.

What this looks like in my practice

Many of the people I work with who have chronic pain have already been through the medical system extensively, sometimes for years. They've had tests, procedures, medications. Some of it has helped; much of it hasn't addressed the full picture.

I work alongside medical treatment, not instead of it. My role is to address the nervous system and trauma components that medical treatment often can't reach, not because doctors aren't doing their jobs, but because those components require a different kind of attention.

We work slowly, at whatever pace the body can tolerate. This is not fast therapy. But for many people, it's the work that finally makes a difference.

Is this right for you?

If you have a history of trauma and chronic pain or illness, and standard treatments have only gotten you so far, somatic and trauma-informed therapy is worth exploring. Especially if you've noticed that stress makes your symptoms worse, or that your body seems to hold tension in ways you can't consciously control.

I offer a free consultation, it's a chance to talk about what's going on and figure out together whether this approach makes sense for you.

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Kate DellaFera is a licensed clinical social worker in Pasadena, CA, specializing in trauma, chronic pain, and burnout. She uses somatic therapy, EMDR, and Brainspotting to help adults whose bodies have been carrying more than their share.