Relationship Between Post Traumatic Stress Disorder and Chronic Pain

Over the past 2 decades, the progress of a greater understanding of functional, mental, and social difficulties commonly associated with chronic pain has progressively evolved. As an outcome, extensive literature presently exists authenticating the connection between chronic pain and conditions such as substance abuse, depression, and anxiety disorders. Researchers and clinicians recognize that these disorders, as well as others, can play a part in chronic pain. Significantly, concern in the association between chronic discomfort and its comorbid illnesses has had a momentous impact on the arena of pain research, it and has added to developments in the conveyance of management programs.

Though some chronic pain illnesses might have a biological etiology and progress slowly over time, other disorders may advance because of an injury from a traumatic event like a car accident, work-related injury, or involvement in the army or other combat branch. Currently, there has been growing interest in the association between pain and PTSD, or Post Traumatic Stress Disorder. Medical practice and research show that the 2 disorders often co-occur and may intermingle in such a way as to harmfully influence the progress and outcome of treatment. Regardless of the current interest, an evaluation of the pertinent literature specifies that there haven’t been enough studies done that link the two co-morbidities together. The absence of meticulous research in this area is disastrous as such educations could considerably advance the treatment for those who suffer with these conditions.

A person who is suffering from PTSD has been exposed to an event that was threatening to them or another person. It causes high levels of anxiety, depression and panic. These people are known to experience substance abuse in a way to help self-medicate. They are known to have nightmares, flashbacks, and to relive the event in their thoughts. They will soon learn to avoid places that trigger these event, even people that bring remembrance to that occurrence. They may also develop problems with anger, rage and irritability from the lack of sleep. They will also feel survivors guild and mentally punish themselves for the situation that was out of their control. While it is often thought of as a problem that happen after one comes home from the war, PTSD is more prevalent in the US than anyone had thought. Roughly 6% of males and 12% of females suffer with this anxiety based disorder. One study found that more than 70% of people have been exposed to a traumatic event that has the potential to cause an anxiety related illness.

A study conducted by Benedikt and Kolb showed that one Veterans Administration clinic had 225 patients that met the criteria for a chronic pain syndrome and also PTSD. When trying to treat the chronic pain issues, it seems that the PTSD was further aggravated. The most common symptoms complained of is back pain and headaches. The study went on to further clinics and together with other researchers, they found that more than 80% of people who had been diagnosed with PTSD also suffered from chronic pain problems. The fact that chronic pain and PTSD are common comorbidities can change how a doctor treats these patients. If a patient suffers from chronic headaches, they are known to have higher levels of depression and anger than those who are not suffering with both conditions. Having both medical problems at the same time can affect the severity of the conditions as they feed off one another. Now that the problem has been identified, working on treating it effectively should be the next step in the process.

Dr. Luis Fandos is a certified anesthesiologist and pain management physician from Babylon, NY.

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