Chronic Pain, Trauma, and the Nervous System

Trauma is unfortunately a very common experience. We often think of it as some really big dramatic event, like war or a plane crash, but it’s often much smaller and quieter than that. Childhood neglect can be traumatic. So can childbirth, the loss of a loved one, and any number of other common events in our lives. My favorite definition of trauma is that it simply means any unhealed wound.

Trauma generally involves some sort of stressful event that overwhelms the nervous system. The body does not feel safe, so it implements all its strategies to help the body return to safety—flooding with stress hormones in order to run, hide, and/or freeze. The problem arises when the body does not get the message that we have indeed returned to safety. Vital systems in the body, including digestion, immune function, and hormonal balance, only work optimally when the body feels safe and relaxed. (Read “Recovering Your Sexuality After Trauma.”)

For some people, chronic pain is the way the body manifests the unhealed wound. Some chronic pain arises because there was an injury once that is still sending pain signals through the body even though the injury has long since healed. But plenty of chronic pain has no known cause.

Childhood trauma is clearly correlated with chronic pain in adulthood. Children who experience trauma, especially over an extended period of time, may suffer consequences in terms of how their bodies process stress. Stress and chronic pain flareups are also clearly correlated, so managing chronic pain must, in some cases, be a question of managing trauma.

Some stress is healthy. Our bodies absolutely need to be able to respond to stressful situations to help us get to safety. But when we never feel safe, when the body cannot return to equilibrium, that stress becomes toxic. The reason is quite simple: the body has limited resources and it can only do so many things at a time. Digestion takes a lot of energy. So does the normal functioning of the immune system. Growth, creating new cells, even thinking critically can take a lot of energy. But survival takes more. When we are under survival stress, the body can’t do any of those other things. When we can never return to safety, we can’t digest, think, or respond to pathogens very well. We are basically always busy surviving.

So for some people, the path to easing chronic pain isn’t about physiotherapy or drugs, though those things may help. Rather, finding healthier ways to manage stress and encourage the body to enter into the parasympathetic rest state may be the key to helping these sufferers.

Yoga is, of course, one of the best treatments for stress relief and pain. It’s important to find a style of yoga that works for you, but Restorative yoga is the absolute best for using specific tools to help calm the nervous system. It does, however, require lying still for up to 10 minutes at a time, sometimes more. Depending on your pain, it might be too confronting to start with that much stillness. Gently flowing movements can also help calm the nervous system, and the introduction of mindfulness practice and a loving attention to the body in a Hatha or a Flow class can go miles toward healing one’s relationship with stress.

Therapy may also be extremely helpful, especially for survivors of trauma. But in my experience, therapy that approaches trauma must be somatic as well as mental/emotional. It must address what’s happening at the level of the body in addition to how the brain understands the past. The problem is not in the mind with chronic pain, after all, it’s in the body. So we must work with the body gently and lovingly to encourage a new way to manage stress and allow the chronic pain signal to decrease over time.