The Interaction Between Chronic Pain and PTSD

Overview

Journal Curr Pain Headache Rep

Date 2019 Nov 30

PMID 31781875

Citations 43

Authors

Shelley Kind

John D Otis

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Post-traumatic stress disorder (PTSD) and chronic pain often co-occur. Understanding the shared mechanisms, signs to identify PTSD, and treatment options is integral in allowing providers to better serve their patients.

Recent Findings: Individuals with comorbid PTSD and chronic pain report greater PTSD symptoms, pain, anxiety, depression, disability, and opioid use than those with only one of these conditions. There are several empirically supported therapies for chronic pain, and for PTSD, as well as pilot data for a treatment of comorbid pain and PTSD. The purpose of this paper is to review and synthesize current literature investigating the interaction between chronic pain and PTSD, and provide treatment recommendations for providers treating patients with chronic pain and PTSD.

Citing Articles

Bidirectional Mendelian randomization study reveals interplay between multisite chronic pain and Post-traumatic stress disorder.

Chen Z, Yang Q, Zhang S, Peng T Sci Rep. 2025; 15(1):7413.

PMID: 40033042 PMC: 11876571. DOI: 10.1038/s41598-025-91715-4.

Posttraumatic Stress Symptoms Moderate the Relationship Between Chronic Pain and Adverse Cannabis Outcomes: A Pilot Study.

DeGrace S, Romero-Sanchiz P, Barrett S, Tibbo P, Cosman T, Atasoy P Cannabis. 2025; 8(1):40-49.

PMID: 39968491 PMC: 11831894. DOI: 10.26828/cannabis/2024/000241.

Shared genetic risk and causal associations between Post-traumatic stress disorder and migraine with antithrombotic agents and other medications.

Bainomugisa C, Bruenig D, Sutherland H, Griffiths L, Nyholt D, Mehta D Neurobiol Stress. 2025; 34:100703.

PMID: 39898008 PMC: 11786899. DOI: 10.1016/j.ynstr.2024.100703.

Phenome-wide diagnostic comparison among suicide deaths and living individuals with chronic pain diagnoses.

DiBlasi E, Kaufman E, Webster S, Hagn E, Shabalin A, Chen D BMC Med. 2024; 22(1):568.

PMID: 39617899 PMC: 11610288. DOI: 10.1186/s12916-024-03794-1.

Epidemiological characteristics of post-traumatic stress symptoms and its influence on length of hospital stay in inpatients with traumatic fractures in Zunyi, China.

Qi G, Dai X, Wang X, Yuan P, Li X, Qi M AIMS Public Health. 2024; 11(3):835-849.

PMID: 39416890 PMC: 11474329. DOI: 10.3934/publichealth.2024042.

References

Wetherell J, Afari N, Ayers C, Stoddard J, Ruberg J, Sorrell J . Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report. Behav Ther. 2011; 42(1):127-34. PMC: 3496779. DOI: 10.1016/j.beth.2010.07.002. View

Dubois M, Follett K . Pain medicine: The case for an independent medical specialty and training programs. Acad Med. 2014; 89(6):863-8. DOI: 10.1097/ACM.0000000000000265. View

Jacobsen L, Schistad E, Storesund A, Pedersen L, Espeland A, Rygh L . The MMP1 rs1799750 2G allele is associated with increased low back pain, sciatica, and disability after lumbar disk herniation. Clin J Pain. 2013; 29(11):967-71. DOI: 10.1097/AJP.0b013e31827df7fd. View

Resick P, Schnicke M . Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992; 60(5):748-56. DOI: 10.1037//0022-006x.60.5.748. View

de C Williams A, Eccleston C, Morley S . Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2012; 11:CD007407. PMC: 6483325. DOI: 10.1002/14651858.CD007407.pub3. View

Nahin R . Severe Pain in Veterans: The Effect of Age and Sex, and Comparisons With the General Population. J Pain. 2016; 18(3):247-254. PMC: 5337168. DOI: 10.1016/j.jpain.2016.10.021. View

Gatchel R, Peng Y, Peters M, Fuchs P, Turk D . The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007; 133(4):581-624. DOI: 10.1037/0033-2909.133.4.581. View

Rosenthal J, Erickson J . Post-traumatic stress disorder in U.S. soldiers with post-traumatic headache. Headache. 2013; 53(10):1564-72. DOI: 10.1111/head.12200. View

Rutt B, Oehlert M, Krieshok T, Lichtenberg J . Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs. Psychol Rep. 2017; 121(2):282-302. DOI: 10.1177/0033294117727746. View

10.

Cornelis M, Nugent N, Amstadter A, Koenen K . Genetics of post-traumatic stress disorder: review and recommendations for genome-wide association studies. Curr Psychiatry Rep. 2010; 12(4):313-26. PMC: 3108177. DOI: 10.1007/s11920-010-0126-6. View

11.

Bohnert A, Ilgen M, Galea S, McCarthy J, Blow F . Accidental poisoning mortality among patients in the Department of Veterans Affairs Health System. Med Care. 2011; 49(4):393-6. DOI: 10.1097/MLR.0b013e318202aa27. View

12.

Fishbain D, Pulikal A, Lewis J, Gao J . Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review. Pain Med. 2016; 18(4):711-735. DOI: 10.1093/pm/pnw065. View

13.

Otis J, Keane T, Kerns R . An examination of the relationship between chronic pain and post-traumatic stress disorder. J Rehabil Res Dev. 2004; 40(5):397-405. DOI: 10.1682/jrrd.2003.09.0397. View

14.

Noel M, Wilson A, Holley A, Durkin L, Patton M, Palermo T . Posttraumatic stress disorder symptoms in youth with vs without chronic pain. Pain. 2016; 157(10):2277-2284. PMC: 5028262. DOI: 10.1097/j.pain.0000000000000642. View

15.

Cleeland C, Ryan K . Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994; 23(2):129-38. View

16.

Bryant R, Guthrie R . Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. J Consult Clin Psychol. 2007; 75(5):812-5. DOI: 10.1037/0022-006X.75.5.812. View

17.

Foa E . Prolonged exposure therapy: past, present, and future. Depress Anxiety. 2011; 28(12):1043-7. DOI: 10.1002/da.20907. View

18.

Velleman S, Stallard P, Richardson T . A review and meta-analysis of computerized cognitive behaviour therapy for the treatment of pain in children and adolescents. Child Care Health Dev. 2010; 36(4):465-72. DOI: 10.1111/j.1365-2214.2010.01088.x. View

19.

Jenewein J, Wittmann L, Moergeli H, Creutzig J, Schnyder U . Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: a longitudinal study. J Trauma Stress. 2009; 22(6):540-8. DOI: 10.1002/jts.20453. View

20.

Hughes L, Clark J, Colclough J, Dale E, McMillan D . Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Systematic Review and Meta-Analyses. Clin J Pain. 2016; 33(6):552-568. DOI: 10.1097/AJP.0000000000000425. View