My trauma occurred in February of 2011. As I stood in front of the podium and spoke at a state summit in Michigan, I recounted my trauma — my past — in front of a room filled with strangers. I shared my vulnerable story and my transition from victim to thriving survivor. As I spoke, my legs shook uncontrollably, my palms were sweaty, and my heart raced.

My speech ended and I stepped down from the podium. The event finally ended. I decided that I must not let this trauma define me and that I must keep speaking. I began traveling and speaking at universities, replaying and recounting my nightmare that had become a reality. Mentally, my mind and body raced, physically my body and back ached. I had tension throughout my spine and episodes of severe constipation.

Survival Mode and the Sympathetic Nervous System

Studies have demonstrated a correlation between mental and physical health, where approximately 15% to 30% of patients with post-traumatic stress disorder also experience chronic pain. So what defines trauma? Trauma is formally defined as “when our ability to respond to a perceived threat is overwhelming, which causes the nervous system to go into survival mode.” During survival mode, the body activates the sympathetic nervous system, which means that “cortisol is constantly released, thus causing an increase in blood pressure and heart rate.”

Trauma affects multiple mechanisms in the body, and the sympathetic nervous system can remain activated for several days to months. When the sympathetic nervous system activates, it can cause somatic pain. So what is somatic pain? Somatic pain is pain that a person experiences without an organic cause. Despite extensive lab testing and imaging, there is not a clear explanation for why a person experiences this type of pain.


Mental and Physical Pain Following Trauma

After trauma, the body undergoes many physical and emotional changes. Evidence supports the following points:

Emotional turmoil and physical pain can feed off each other. Trauma can be overwhelming. Evidence has shown that emotional pain from trauma can lead to an increase in somatic pain by fifty percent. A person who is experiencing chronic pain in the absence of physical injury should consider whether their past trauma could be a contributor.

Mind and body linkages can influence pain responses. Chronic states of stress can lead to activation of the sympathetic nervous system, thus causing the body to create more pain.

The association between pain and post-traumatic stress disorder (PTSD) is complicated and still not well understood. This does not change the fact the pain is real. Evidence shows that post-traumatic stress disorder is a state of heightened arousal, where the body is more prone to pain. Patients with PTSD have shown “to experience expectations of pain, before a noxious stimulus actually occurs.”

Pain is Multidimensional

Pain is not always the result of physical injury. When treating pain, one should consider multiple factors by obtaining a thorough history. Correspondingly, multimodal therapies must be implemented to address pain such as: counseling, medication management, and physical therapy.

As I stepped up to the podium in front of the audience, my voice quivered as I stated, “It was a long hard road, I lost myself but I found my voice.” I used my voice to speak up and find help through weekly therapy sessions, and, in turn, I have used my voice to advocate for others who’ve been through the same emotional pain as me.

Lauren Debski, FNP