PTSD Bytes – PTSD and chronic pain

In this episode of the PTSD Bytes podcast, host Dr. Colleen Becket-Davenport discusses PTSD and chronic pain with Dr. Jennifer Murphy, national director of VA's Pain Management program and lead author for the VA's Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) initiative and Dr. Katie Hadlandsmyth, clinical pain psychologist and health services researcher at Iowa City VA and the University of Iowa.

Understanding chronic pain

When we think of pain, we often think of acute pain, which is typically short-term, caused by a specific injury and resolves within a few months. Chronic pain, on the other hand, lasts longer than three months and often extends years or decades. About one in four people in the U.S. have chronic pain and the prevalence is even higher among the Veteran population.

Pain is not only physical, but can also affect other aspects of life, such as how you interact with your family, your mood and your participation in personal interests. Psychologists who specialize in working with people who experience chronic pain can be helpful. Pain psychologists will listen to the person with pain and offer advice on ways to manage and respond to the pain so it doesn't interfere as much with your life.

Most of us avoid activities if we think it will cause us more pain. However, too much avoidance can be counterproductive in the long run, because it could lead to greater pain or make us more susceptible to injury. Pain psychologists can help you better understand your own pain, what you can do to manage it most effectively and live the best life possible.

PTSD and chronic pain

PTSD and chronic pain are often linked. Fifty percent of Veterans with PTSD also report suffering from chronic pain. The reasons for this are complex. Some research shows that a history of trauma can alter how the nervous system processes pain, making individuals more sensitive to it. Children exposed to trauma may develop pain sensors that are more attuned to discomfort, increasing the risk of chronic pain in adulthood. The symptoms of PTSD and chronic pain tend to magnify each other.

Like PTSD, chronic pain is often misunderstood because its symptoms are not always visible. People with chronic pain often do not feel heard or believed, and this can make it difficult for individuals to seek help.

Treatment for both PTSD and chronic pain

Treatment for people who experience both chronic pain and PTSD typically includes multiple approaches with multiple types of health care providers. It is common for people to get their PTSD treatment through mental health specialists and pain care either through primary care, specialty pain clinics or rehabilitative services.

This is most effective if the different health care services are working together to coordinate care. Another approach-and this is becoming increasingly available at VA-is combined treatment. This means a Veteran could go to a single provider or team to treat their chronic pain and PTSD simultaneously.

Outside of treatment, there are also many helpful non-pharmacological and self-management approaches geared toward empowering individuals, helping them achieve their goals and providing them with ideas for how to make changes they desire despite the pain.

One helpful self-management tool is VA's Pain Coach mobile app, which offers a broad range of tools and videos to help with pain management and other areas impacted by pain, such as sleep. The app includes education and resources, such as activity pacing and relaxation techniques, in addition to customizable daily check-ins that are linked to helpful tools.

Additional links

If you are a Veteran who is experiencing a crisis or supporting a loved one who is, call 988 and press 1 for immediate assistance, or chat online at VeteransCrisisLine.net/chat.

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