Psychological or emotional trauma and chronic pain

For some people, chronic pain is closely linked with trauma — particularly experiences that left the body feeling unsafe, overwhelmed, or out of control.

Trauma doesn’t have to mean a single dramatic event. It can include:

• Childhood adversity or neglect

• Emotional, physical, or sexual abuse

• Medical trauma (painful procedures, not being believed, repeated hospitalisations)

• Military service, accidents, or serious illness

• Living for long periods under stress, fear, or instability

These experiences can shape how the nervous system develops and responds to threat.

Trauma and the nervous system

When someone experiences trauma, the body learns to prioritise survival. The nervous system may become:

• Hyper-alert to danger

• Faster to trigger pain signals

• Slower to return to a calm, regulated state

This can mean the brain is more likely to interpret sensations as threatening, increasing pain intensity and persistence — even long after the original danger has passed.

Importantly, this is not a conscious process and not something people choose. It is the body doing its best to protect itself based on past experience.

Trauma does not mean the pain is psychological

Pain linked with trauma is still real, physical pain.

Trauma affects the nervous system, immune system, hormone levels, muscle tension, and pain processing pathways. The pain is not imagined, exaggerated, or “just emotional” — it is the result of very real biological changes in how the body processes threat and safety.

Why this understanding matters

Recognising the role trauma can play in chronic pain helps:

• Reduce shame and self-blame

• Explain why pain can flare with stress, conflict, or feeling unsafe

• Shift treatment away from “fixing damage” and towards restoring safety and regulation

For some people, addressing trauma alongside physical rehabilitation can significantly reduce pain intensity and improve quality of life.

A trauma-informed approach to pain

A trauma-informed pain approach focuses on:

• Creating safety and trust

• Working at the person’s pace

• Supporting nervous system regulation

• Avoiding “push through” messages that can worsen symptoms

• Integrating physical, psychological, and social care

This does not mean revisiting or reliving traumatic events unless someone wants to.

Often, the work is about helping the body feel safer in the present.