Chronic Pain and Trauma: What Emerging Research Is Teaching Us
Pain does not always arise solely from tissue damage. Increasingly, research into chronic pain recognises that the nervous system, stress physiology and lived experience all influence how pain is experienced.
The term somatisation describes the experience of psychological distress expressed through physical symptoms. This does not mean the pain is imagined — rather, it reflects the complex interaction between mind, brain and body.
Trauma and the Body
Emerging research in neuroscience and trauma studies suggests that overwhelming or prolonged stress can alter nervous system regulation. Authors such as Bessel van der Kolk have helped bring attention to how trauma may influence physiological patterns, not just psychological experience.
In a well-regulated nervous system, perceived threat activates the fight-or-flight response. Stress hormones such as adrenaline and cortisol prepare the body for action. Once safety is restored, the system typically settles back into equilibrium.
However, in situations of prolonged or unresolved threat, this regulatory system can become sensitised. From a trauma-informed perspective, the body may continue to respond as though danger is present, even when it is not.
This ongoing dysregulation is increasingly recognised in pain science as a contributor to persistent pain patterns in some individuals.
Chronic Pain and Nervous System Sensitisation
Modern pain research acknowledges that chronic pain can involve changes in how the nervous system processes signals — sometimes referred to as central sensitisation.
In these cases, pain is real and distressing, even if ongoing tissue damage is not present. Sleep disruption, emotional stress and previous trauma can all influence pain sensitivity.
Understanding this interaction between nervous system regulation and pain can open additional therapeutic pathways.
A Trauma-Informed Physiotherapy Approach
As a physiotherapist working in trauma-informed care, my approach integrates:
• Contemporary pain education
• Nervous system awareness
• Evidence-based trauma-informed techniques
• Gradual functional rehabilitation
The aim is not to “erase” pain, but to support improved regulation, reduced pain sensitivity and increased functional capacity over time.
Not all chronic pain has its roots in trauma. However, research continues to explore the relationship between stress physiology and persistent pain.
A trauma-informed lens allows us to consider these interactions carefully and compassionately within a structured, evidence-informed framework.
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