Childhood Trauma and Adult Pain: Is There a Connection?

Childhood Trauma and Adult Pain: Is There a Connection?

Seven out of 10 women with chronic pain report having one or more incidents of childhood trauma, according to the results of a survey that found nearly half the women had experienced emotional abuse as children.

Young girl upset, crying with tearsThe online survey of over 2,400 women in chronic pain was conducted by National Pain Report and For Grace, a non-profit devoted to better care and wellness for women in pain.

Although many health professionals believe there is an association between childhood trauma and chronic pain, over half the women surveyed do not believe their pain is linked to physical or emotional trauma.

“Whether you acknowledge it or not, it (childhood trauma) will be impacting your health, your emotional well-being, and your pain. It does. It just does. And that’s just a fact,” said Beth Darnall, PhD, a pain psychologist and author of Less Pain, Fewer Pills. “If you’re exposed to trauma and you’re a woman, you are more likely to subsequently develop chronic pain.

“Trauma and sexual abuse unequivocally predicts the development of chronic pain later in life. That’s doesn’t mean that people are saying it’s your fault or anything like that. But the science is indisputable.”

types of abuseNearly 44% of the women surveyed said they experienced emotional abuse, making it the most common childhood trauma.

Bullying (35%) was the second most common trauma, followed by sexual abuse (28%), witnessing domestic violence (24%), physical abuse (23%), and death of a parent or close loved one (17%).

Nearly 29% of women said they did not have any childhood trauma.

 

“I was raped when I was a teen and was working after school because my mother was very ill and had only been given months to live and my grandmother was an invalid and so I worked after school so as to help care for my family. I was raped and didn’t tell anyone for several months,” wrote one woman who has fibromyalgia, migraines, rheumatoid arthritis and other chronic pain conditions.

“Low income. Often no money for basics, especially food. The memories of feeling hungry all the time, and thinking about food longingly, are far worse than memories of the abuse by my mentally ill mother,” said another woman, who suffers from migraine, osteoarthritis, neuropathy and other conditions. “I never told any friends or teachers that I didn’t get enough to eat. It was humiliating.”

“Attacked by a dog, face/mouth torn apart, had to have many, many surgeries as a young child,” wrote a woman who now suffers from fibromyalgia and migraines.

“My mother was very difficult, abusive to us and our father. She was, in retrospect the victim of some abuse herself and very likely had fibromyalgia. She was in constant pain following menopause and the doctors dismissed her pain as all in her head. Sister and I sexually abused by an older cousin and a babysitter’s sons when we were quite tiny,” said a woman who has fibromyalgia, osteoarthritis and back pain.

childhood trauma linkWhile childhood trauma was common, only about one in five women (22%) think there is a connection to the chronic pain they have as adults. Over 55% do not think their pain is linked to a physical or emotional childhood trauma.

“I dislike it when doctors attempt to tie chronic illness to childhood trauma, particularly in cases where women are treated like their disease/pain is ‘all in their head’ if they have experienced trauma or abuse,” wrote a woman who said she experienced emotional abuse and bullying as a child.

But many psychologists say there is ample evidence such a connection exists – that childhood trauma can “rewire” the brain and central nervous system.

“I think what we’re starting to appreciate is that when you have traumatic experiences as a young person, it rewires you. And the way in which you interpret physical symptoms is changed forever,” said Steve Passik, PhD, a psychologist and Vice President of Research and Advocacy for Millennium Health.

“We’ve come to learn that it’s not just a psychological thing. That there are neurobiological causes that change the nervous system. Painful stimuli are wired differently in people who have those kinds of histories.”

In the National Pain Report survey, women who reported childhood sexual abuse were more likely to have fibromyalgia than women who were not sexually abused (69% vs. 60%).

They were also slightly more likely to suffer from back pain (65% vs. 60%), migraine (37% vs. 34%), osteoarthritis (39% vs. 34%) and neuropathy (31% vs. 27%).

That dovetails with previous research showing that about 90% of women with fibromyalgia reported some type of trauma either as children or adults.

Dr. Beth Darnall

Dr. Beth Darnall

“We see a clear association with childhood trauma, biochemical dysregulation and subsequent development of fibromyalgia. We can’t say 100% causally, but there is a clear association here,” said Dr. Darnall. “So it isn’t ‘Oh this is all in your head.’ When we experience something awful, it changes our body. It changes our brain and our body. It changes our biochemistry and it even has the ability to turn on certain genes that would have negative consequences.

“So let’s move forward. Let’s get over the fact that if a doctor tells me that you were abused you need to have counseling for that. That person may be doing you the best service of your life. And they’re not stigmatizing you just because you’re a woman.”

But many women think they are being stigmatized. And nearly one in five (18%) of those surveyed said a doctor had told them their pain was caused by childhood trauma.

“The doctor said that I wouldn’t have to go to the doctor so much if I addressed my psychological issues. He then said that I had probably been sexually abused and that caused my pain. I have never been sexually abused. When a doctor says something like that it is disturbing,” wrote one woman.

“Since I have PTSD (post-traumatic stress disorder) from a violent spouse (now in prison for murder) they almost always blame the pain on my mental trauma. I don’t think I’d be so depressed if I wasn’t constantly in serious pain and could work and support myself like I did for 40 years,” wrote another woman.

“I will not share my true history with my doctors. The last thing I need is to be marked as a potential addict due to child sexual and physical abuse,” said another survey respondent.

Darnall says it’s a mistake for women in pain to avoid counseling or psychological help.

“I think a really important message for women to hear is that there are significant and lasting consequences from negative events and we have to honor that and look at that for what it is,” she said. “And if that involves counseling, that involves counseling.”

To see the full results of the “Women in Pain” survey now, click here.

Authored by: Pat Anson, Editor

There are 9 comments for this article
  1. Barbara at 2:55 pm

    I have wondered this fact/premise myself after being traumatized for years and molested for years from a neighbor and having a traumatic head injury at 10 from a playground accident. I also had a mother who was, I suspect, high functioning Aspergers Syndrome. I found a great number of other women who have chronic pain also had trauma in some way and I believe it is a form of PTSD that changes our nervous system.

  2. dibaby at 10:07 pm

    All this proves is that an incredible chunk of society has suffered abuse as children. You’d have to question all people and see how many suffered abuse that did not have chronic pain. Also abuse often, not always, but often is linked with other factors such as poverty. How many of these women lived in substandard housing? Exposed to heavy metals, like lead, in utero and while growing? How many were malnourished while they were still developing in utero? Or were exposed to things like drugs, alcohol or cigarettes in the womb? The fact that they were abused is probably a coincidence, an unfortunate side effect of a bigger social problem. I think there is probably a link between poverty and chronic pain as an adult, but not abuse.

  3. Kimberly Kay Miller at 8:03 pm

    I have questioned many times why women are so much more likely to be afflicted by Fibromyalgia and other diseases that are related to it. The last thing I expected to factor into it was that our parents, childhood bullies or childhood molesters could be the reason for a great deal of it. Talk about adding insult to injury, and in many cases, injury to injury.

    Ever get the feeling things are just being over-simplified to appease those who are at it again? In other words, first we were raped, bullied, or emotionally tormented or all of the above, now we know that had we just not let that happen, we wouldn’t be whining about some pain that many doctors still think is a fictitious disease (fibromyalgia) and come to find out, just like everybody thought, there was really nothing wrong with them after all.

    Seems all too convenient to me. But, that’s just one woman’s opinion who had a drinking, mean and emotionally abusive father and a mother who had (has) so many issues herself, my brother and I were really just in the way. Even at that, of the two of us, I was certainly not her favorite.

    Maybe there is something to this, guess all we can do is wonder why some people choose to have children at all.

    ***** SEPTEMBER IS PAIN AWARENESS MONTH ******

  4. BL at 6:31 pm

    Dennis Kinch, You’ve made some very good points. It is almost impossible, if not impossible, for the young drs of today to remember that we haven’t always had the EPA and the FDA Drug Watch, etc. When people were exposed to things that were bad for them over many yrs and never knew it was harming them.

    The childhood trauma, or any trauma that isn’t overcome can cause physical problems. I’m saying there is a possibility it may be that along with/or a number of other things. I just wonder how much more someone who had already suffered in ways that other can’t imagine, will be made to suffer more while the powers are trying to figure this all out instead of prescribing medications to ease the symptoms.

  5. Dennis Kinch at 3:10 pm

    to BL: In my case the answer is Yes. I was told just about everything detrimental that I’ve seen here by many doctors. 2 went so far as to say i threatened them and their family’s lives! 3 (different ones) lied on forms to get my insurance dropped. 2 left me lying on the floor of their office, (actually left the building), while my flare-up went through its course. They were disgusted that steroid shots didn’t work and said I caused them not to work because my psychosis of pain was so high! These 2 incidences were 5 years apart in 2 different states! I’ve had about 20 doctors in 10 years. All but 3 felt most of what I had was “in my head” – tied to past emotional stress and abuse.

    I was wondering the other day where all these “new age” pain diseases were coming from. I know my original one, sciatica, was a common diagnosis in the 50’s and 60’s and in the 70’s research found that “sciatica” was actually caused by many different diseases and injuries which are now diagnosed.

    Since my own bone disease is rare and there are no doctors like “House” out there, it was called many things and doubted by many doctors, the most recent was last year when the Medicare folks needed a reason not to approve an MRI. This is 9 years after my diagnosis which took 4 years to get! I believe a lot (80%) of the emotional stress diagnoses are in the category of “needing a reason to refuse services.”

    I can see there’s a lot of stupidity to weed through before we can actually get to the truth, probably not in my lifetime anyways, but I’m still always curious as to the root of these diseases.

    So, weeding out the non-professional opinions I personally have experienced, there is still a part of me that entertains the possibility of my abuse ( mental, physical, sexual and emotional) being the underlying reason for a bone marrow disease, but it seems like more of a stretch than say, a virus from a familial gene, or chemical fallout side effects. Since most of us lived through the “pre-EPA” days of chemicals in everything, this seems like the best source to me.

    Someday research can be done to get to the truth but it will take being truthful on everybody’s part first, even those docs that are the opposite of “House”… ( are they called “Garage” or Shack?”)

  6. BL at 9:23 pm

    LarryK, The study is true to a point. I just wonder if this is possibley another reason for women/patients to have their pain dismissed ? The counseling and community resources are so much better than they were in the past. I worked with victims of sexual assualt and domestic violence for a number of yrs, many yrs ago. Sometimes the pain stems from physical injuries. I just hate to see someone suffer because they are lumped together and not treated as individuals. Often those that survive and overcome these traumas are stronger than people who didn’t suffer them.

  7. John Quintner at 7:22 pm

    Dear Editor, may I add some insights to this interesting topic?

    The systems that underlie the human stress response (SR) are multiple, co-modulatory and co-regulatory. Almost from the moment a SR is activated, countervailing processes are also activated, to ensure that the dramatic molecular events marshaled to save the animal don’t themselves do damage.

    This is because many molecular actors involved in SRs are ‘double-edged,’ and can have negative as well as positive effects on organism functioning. The response to stress thus is designed to engage, repair, and stop (resolve).

    When an SR is prolonged in any organism, for whatever reason, profound changes occur in functioning and behaviour. Chronic SR activation in humans is associated with some of the most medically important diseases in the developed world, including cardio-vascular disease, type 2 diabetes, and metabolic syndrome.

    From this perspective, Chronic Widespread Pain (fibromyalgia) can be seen as a clinical outcome of prolonged activation, or dysregulation of a complex, evolutionarily conserved system designed to defend the organism against threat.

    We also know that SR systems are among the most genetically and phenotypically variable systems in biology. This perspective may help to explain the great differences between individuals in the clinical presentation of such conditions as Chronic Widespread Pain (fibromyalgia).

    Stress response systems in mammals are highly susceptible to modification in early development, producing different stress reactivity profiles, so childhood exposures to stressors, including serious disease or injury, may be relevant to the clinical presentation in adult life.

    So what the survey seems to show is that significant traumatic events (stressors) encountered in early life can have serious repercussions in later life by increasing the reactivity of SR systems. However, not every person who experiences such traumatic events is going to be more susceptible to these phenomena in later life.

    Reference: Lyon P, Cohen M, Quintner J. An evolutionary stress-response hypothesis for Chronic Widespread Pain (Fibromyalgia Syndrome). Pain Med 2011; 12: 1167-1178

  8. LarryK at 6:00 pm

    BL: I was down that road with my fibromyalgia. I had that dismissal. I was told 3 times that it was all in my head. 3 times the counselor said no. I’ve since moved past my childhood trauma of being abused by my stepfather for years, and being relentlessly bullied in school. The pain has not even close to subsided. I have only become more adept at working with it. That was only after trying suicide, and thinking of suicide for years.

    To further expand on the article itself, the counselors told me that there are problems that arise from abuse in the brain. When someone is in the fight or flight mode, chemicals flood the brain. They are supposed to help calm you down so you can deal with the situation. In abuse victims, a lot of times those chemicals don’t do that due to the situation. The chemical ends up flooding over and over. This causes damage to the pathways in the brain. It is said to at least cause cognitive issues, and sleep disorders (which I have still at age 35.)

    The side symptoms for me, were the first thing to surface for my fibromyalgia (which is small fiber fibromyalgia.) Hot flashes, memory dysfunction, sleep disorders (I’d only sleep once every 3 days for years), migraines and probably more I’m forgetting were all there a few years before the pain kicked in. I’d love to see a full study done on men with fibromyalgia. I’ve seen some rumors that just as many men have it as women. I’d love to see an actual study done regarding this and, the abuse angle. I’d be willing to bet that the chance of getting fibromyalgia is going to end up being a variety of factors that have to lock in like a puzzle to cause it.

  9. BL at 5:04 pm

    I wonder if a man, who said he suffered trauma as a child would be treated the same as a women ? In other words told to get counseling and have their pain dismissed ?