How Pain and PTSD Occur Together

Depressed woman with head in hands
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If you have posttraumatic stress disorder (PTSD), your doctor may have explained that you're at higher risk for other health problems such as depression and heart disease. But you may be surprised to learn that people with PTSD are also more likely to have problems with pain than people who don't. What's the story behind PTSD and pain?

PTSD and Pain Frequency

Studies show that pain is one of the most common physical problems reported by people with PTSD. This finding holds true no matter what types of traumatic events they experienced—for example, a motor vehicle accident, physical assault, or combat injury. People with PTSD are also more likely to report pain-related disability.

  • In one study of volunteer firefighters with PTSD, approximately 50% were having pain (mainly back pain) compared with only about 20% of firefighters without PTSD.
  • In two other studies, from 20% to 30% of patients with PTSD had frequent and chronic pain symptoms.

You can also look at this situation in reverse. Many patients with chronic pain problems also have PTSD. In fact, from 10 percent to 50 percent of people getting treatment for chronic pain have PTSD as well. These rates of PTSD are higher than those found in the general population.

Why Do They Occur Together?

One reason is obvious: Many traumatic events cause pain. Severe traumatic events, such as living through a natural disaster, physical assault, or combat, can inflict serious injuries that lead to chronic pain.

The more severe the traumatic event, the more likely it is that severe injury, along with PTSD, will result.

The second reason why PTSD and pain occur together so often isn't as obvious, but it's just as important to know: Some symptoms of PTSD may cause pain. For example, PTSD-related hyperarousal symptoms often cause tense muscle pain that can become chronic.

Then there's the pain that can be caused by other disorders that commonly occur with PTSD, such as depression, which is common in people with PTSD and can make them more likely to avoid or scale down physical activities that were helping them stay fit. This may result in poorer health and even disability--increasing their risk of developing pain problems.

Treat Both for Best Results

If you have both PTSD and pain, getting treatment for both can make a big difference in how you feel.

Since PTSD symptoms can give rise to pain, getting treatment for them may help you prevent or reduce pain problems. Considering PTSD treatment? You can use the Anxiety Disorder Association of America to find PTSD treatment providers in your area.

If you already have trauma-related pain and PTSD, getting treatment may help with two types of problems:

  • Your physical pain
  • The upsetting PTSD symptoms pain from trauma can trigger, such as memories or thoughts about your traumatic event
3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Fishbain DA, Pulikal A, Lewis JE, 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. 2017;18(4):711-735. doi: 10.1093/pm/pnw065

  2. Moeller-bertram T, Keltner J, Strigo IA. Pain and post traumatic stress disorder - review of clinical and experimental evidence. Neuropharmacology. 2012;62(2):586-97. doi:10.1016/j.neuropharm.2011.04.028

  3. Brennstuhl MJ, Tarquinio C, Montel S. Chronic Pain and PTSD: Evolving Views on Their Comorbidity. Perspect Psychiatr Care. 2015;51(4):295-304.doi:10.1111/ppc.12093

Additional Reading
  • Asmundson, G.J.G., Coons, M.J., Taylor, S., & Katz, J. (2002). PTSD and the experience of pain: Research and clinical implications of shared vulnerability and mutual maintenance models. Canadian Journal of Psychiatry, 47, 930-937.
  • Roth, R.S., Geisser, M.E., & Bates, R. (2008). The relation of posttraumatic stress symptoms to depression and pain in patients with accident-related chronic pain. The Journal of Pain, 9, 588-596.
  • Sharp, T.J., & Harvey, A.G. (2001). Chronic pain and posttraumatic stress disorder: Mutual maintenance? Clinical Psychology Review, 21, 857-877.

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.