The Connection of Chronic Pain to Childhood Trauma
It's a daily news occurrence to hear about the opioid epidemic. While we hear about how opioid addiction has taken lives, ruined families and even destroyed small towns, we hear little about the frequent culprit behind all of this: pain.
Do you suffer from chronic pain? Do you understand pain, it's purpose, and how it can actually become overly protective of our bodies through conditioning?
Do you know that the United States has by far the highest rate for chronic pain than any other country in the world? Last year in the U.S. there were 51,335 opioid deaths. Consider the following:
- The number of people becoming addicted to and dying from opioids is directly related to the number of opioids being prescribed.
- Research shows that oral opioids are less effective than acetaminophen or NSAIDs in treating acute pain. (For acute pain, Cochrane Reviews reveal that oral opioids are less effective than other options.)
- Opioids have worse outcomes than the other options.
Pain has a very specific purpose to our bodies. It is an alert system that helps to protect us from danger.
Chronic pain is different from acute pain, in that it lasts more than 3 months. Acute pain is typically the result of an injury or a surgery.
Our body sends alert messages to our brain through our central nervous system. These messages tell our brain that something is wrong. Our bodies experience pain from different kinds of perceived danger; infections; accidents; physical, emotional and sexual assaults of all kinds; surgery; and even gross negligence. When we experience any kind of danger, there are "pain" signals sent to our brain warning of the danger and all these signals travel the same neural pathway.
So, when we have pain, the pathway to our brain informing us of the danger is used repeatedly. This is the same pathway that is used for transmitting information to our brains about stress, trauma, fear, etc. Using this pathway repeatedly may cause over sensitization of the neurons, which means the longer your body produces pain, the better your body will get at producing the sensation of pain. If you are interested in learning more about how pain works, you may want to watch videos on these websites:
Evidence based research shows us that opioids ARE NOT very effective in reducing pain and the side effects are devastating. In fact, we can relieve pain better by prescribing fewer opioids. There are evidence-based approaches for managing chronic pain. Cognitive Behavioral Therapy, more commonly called CBT, is a treatment modality which helps people modify their thoughts. CBT is used to treat all kinds of issues including anxiety, depression, low self-esteem, agoraphobia, eating disorders and more. It is also used to treat and reduce chronic pain.
Research has shown a high rate of chronic pain in those who have a significant history of trauma, particularly childhood trauma. The most common childhood trauma includes:
- physical abuse
- sexual abuse
- emotional abuse
- mental illness of a household member
- problematic drinking or alcoholism of a household member
- illegal street or prescription drug use by a household member
- divorce or separation of a parent
- domestic violence towards a parent
There are many other types of trauma besides those listed above: such as being homeless, losing a caregiver, witnessing domestic violence, discovering a deceased caregiver, or being in a serious accident or a fire.Neglect as well as abuse can be what is known as an "adverse childhood experience."
Trauma is best treated in individual therapy. But the connection between that trauma and the experience of chronic pain is the focus of the Chronic Pain Group offered at Family Guidance Centers. In this eight-session group there is an evaluation process which is done individually. Members are encouraged to look at the history and development of their own chronic pain and this usually means looking at how adverse experiences in childhood were processed. If you are interested in knowing more about the Adverse Childhood Experiences assessment tool, here is a link:
Pain is different for everyone. There are so many options for pain relief and other treatments: NSAIDs like acetaminophen and ibuprofen, painkillers that are addictive, other medications like gabapentin and Lyrica which were developed but found to help mitigate pain. Then there is physical therapy, acupuncture, chiropractic, surgery, magnet therapy, and massage just to name some of the many options that are available to health care consumers. But do any of these things actually help us understand pain and how to relieve it?
The Chronic Pain Group begins with getting some education about pain and how the brain manages pain. Then the focus is on learning skills to help reduce pain. The approach is cognitive, meaning that we look for the connection between our thoughts and how they may affect our emotions and behaviors. We also learn about Mindfulness and explore the benefits of meditation. Members share their own stories about experiences with both good and bad resources that they have encountered. Additionally, there is great support. Members are usually surprised to learn that there are other people who are experiencing many of the same feelings and experiences.
Through education, Cognitive Behavioral Therapy, mindfulness, and meditation you may learn better ways to reduce or even overcome pain. You may find that you are able to control chronic pain without resorting to aggressive treatments like therapy or by taking a daily regimen of medications, especially opioids.
If you think you might benefit from learning more about chronic pain and its connection to trauma, please call our office to get more information.
Teresa Wulf-Heller, LCSW is a Clinical Associate with Family Guidance Centers. She provides individual, adolescent, and family therapy. She can be reached at 804-743-0960 or can be emailed at firstname.lastname@example.org.
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