Childhood Trauma Increases the Long-Term Risk of Chronic Pain

A young woman rubs her neck.

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It’s common knowledge that traumatic childhood experiences like abuse and neglect can have a lifelong impact on mental health, but it turns out they can have a serious impact on physical health, too.

In a recent paper published in the European Journal of Psychotraumatology, an international team of researchers reviewed the results of 85 studies examining adverse childhood experiences and chronic pain. The studies collected information on about 826,452 adults 18-90 years old living in North America, Europe, Australia, or Asia.

The researchers found that any direct traumatic experience in childhood – like physical abuse, emotional abuse, sexual abuse, or neglect – increases a person’s chances of suffering from chronic pain in adulthood by 45 percent, and the odds rise with each additional traumatic event. Children who endure four or more adverse experiences are 95 percent more likely than their peers to grow into adults with chronic pain.

One in five Americans lives with chronic pain, and pain disorders are a leading cause of disability worldwide. Common types of chronic pain include lower back pain, arthritis, and migraines. These conditions can affect a person’s daily life to the point that they can no longer participate in physical activities, sit comfortably at a desk, sleep soundly, or eat properly.

“These results are extremely concerning, particularly as over 1 billion children – half of the global child population – are exposed to ACEs each year, putting them at increased risk of chronic pain and disability later in life,” says lead study author André Bussières of McGill University’s School of Physical and Occupational Therapy. The burden is particularly high in low- and middle-income countries, where an estimated 59 percent of children experience adverse childhood events each year, compared to 44 percent in high-income countries.

Beyond its devastating personal impact, chronic pain comes with high economic price tag. Medical expenses and lost productivity associated with chronic pain cost the U.S. economy alone $560-$635 billion each year. This is a greater annual cost than heart disease and cancer combined.

It isn’t yet clear why early trauma predisposes a person to chronic pain. The toxic stress arising from childhood abuse or neglect can disrupt the development of the brain and other organs, which may lead to stress-related disease and cognitive impairment in adult life. There’s also emerging evidence that childhood trauma can alter the way genes are expressed, causing structural and functional changes in the body.

The researchers hope their findings will show the need for trauma-informed care in the pain management field. Recognizing adverse childhood experiences as a risk factor for chronic pain and disability could allow for early intervention and tailored treatment strategies.

Says Bussières, “There is an urgent need to develop targeted interventions and support systems to break the cycle of adversity and improve long-term health outcomes for those individuals who have been exposed to childhood trauma.”