The Connection Between Chronic Pain and PTSD

The Connection Between Chronic Pain and PTSD

The Albany Clinic • July 1, 2022

If you have post-traumatic stress disorder (PTSD), you may know that you’re at an increased risk for a variety of other disorders, including depression and anxiety . But did you know that there is also a correlation between PTSD and some physical conditions, such as IBS and chronic pain ?

While the reasons behind the link between chronic pain and PTSD aren’t entirely known, it has been proven that they are related. In fact, a study in the Psychiatric Times has shown that the prevalence of chronic pain among patients with PTSD may be as high as 80% . 

This can be due to a variety of factors, including the way that chronic pain affects the brain. Unfortunately, many people do not realize they have both conditions or how the two conditions affect each other. Keep reading to learn about the relationship between chronic pain and PTSD.

What Is PTSD? 

PTSD is a mental health condition that’s triggered by a traumatic event. This could be a single life-changing event, such as a car crash, robbery, or near-death experience, or it can manifest from a series of traumas, such as childhood abuse or military service. Both experiencing or witnessing an event can cause PTSD. 

Symptoms of PTSD include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. It can lead to problems with memory and concentration, making it hard to continue with everyday activities. It can also cause insomnia, irritability, and avoidance of anything that reminds you of the trauma. 

What Is Chronic Pain?

Chronic pain is defined as any pain that lasts for more than six months. It can be caused by an injury, a health condition, or even psychological factors. In most cases, it constantly persists for weeks, months, or years, which causes a significantly lower quality of life for the sufferer. Common types of chronic pain include:

  • Arthritis
  • Back pain
  • Nerve pain 
  • Headaches and migraines
  • Stomach pain

Chronic pain can be extremely debilitating, making it hard to concentrate, sleep, or even perform basic tasks. The pain can vary in intensity and may come and go over time. Chronic pain may, over time, lead to psychological effects, including depression, anxiety, anger, and fear of making an injury worse.

The Link Between PTSD and Chronic Pain

There are a few theories on how PTSD and chronic pain may be linked . The following are a few of the most popular ones.

Pain Caused by a Traumatic Event

The most obvious explanation for the link between chronic pain and PTSD is when the pain is sourced from the traumatic event that caused the PTSD. This event could be a car accident, a fall, or any other type of physical trauma. The pain may be caused by an injury sustained during the event or could develop over time. 

Shared Vulnerabilities

Studies show that PTSD and chronic pain could have shared underlying vulnerabilities. Anxiety sensitivity, or the tendency to respond to an event with fear, may amplify the emotional response someone has to a traumatic event, which increases the risk of both conditions developing. 

Feelings of loss of control and a lowered physiological threshold for alarm due to trauma can also cause hypervigilance and muscle tension, increasing the chances of chronic pain developing.

Pain Sensitivity Differences

Research shows that patients with PTSD often experience hyperarousal (a prolonged state of the flight-or-fight response staying triggered) and dissociation, both of which can increase or decrease pain perception. For patients with reduced pain perception, chronic pain can more easily develop and impact quality of life more severely.

Mutual Maintenance and Exacerbation

Finally, PTSD and chronic pain may be linked simply because the two conditions happen to have symptoms that may exacerbate each other. 

Pain may serve as a traumatic trigger, especially for patients whose trauma stemmed from a physically painful event, which can cause hyperarousal and fear. This hyperarousal and fear may, in turn, cause a patient to focus on their pain more than usual. Hyperarousal by itself can also cause prolonged muscle tension, leading to the development of chronic pain.

Treatment Options

PTSD can have a profound effect on your mental health, but it can also lead to physical symptoms such as gastrointestinal problems, headaches, chest pain, and other types of chronic pain. 

While the specific reasons behind these symptoms vary, the chronic stress PTSD generally puts your body through leads to an increased likelihood of developing chronic pain.

When dealing with both PTSD and chronic pain, treatment methods can be a bit difficult to navigate. Few options tackle both issues at once, and sometimes treatment for one can get in the way of treatment for another. Nevertheless, the following are a few methods that have proven successful.

Therapy

Cognitive-behavioral therapy , or CBT, is a type of therapy that has been shown to be effective in treating both PTSD and chronic pain. This form of therapy focuses on helping you change the negative thoughts and beliefs you have about your condition. 

CBT can help you develop new coping mechanisms for dealing with your chronic pain, as well as provide you with tools to deal with your PTSD symptoms.

Lifestyle Changes

Making lifestyle changes is another crucial step in managing both PTSD and chronic pain. Exercise, relaxation techniques, and a healthy diet can all help improve your symptoms. 

Exercise can be especially helpful in treating chronic pain, as it releases endorphins, which are natural painkillers. Relaxation techniques, such as yoga and meditation, can also help you manage your pain by helping you focus on something other than your symptoms.

Medications

There are a few different types of medications that can be used to treat both PTSD and chronic pain. 

Anti-inflammatory drugs, such as ibuprofen, can help reduce inflammation, which can in turn help relieve pain. Antidepressants and anti-anxiety medications can also be useful in treating both conditions.

Other options, such as opioid painkillers and sedatives, may be necessary for patients with more severe symptoms. However, these medications come with a high risk of abuse and addiction, so they should only be used as a last resort.

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Stellate Ganglion Block (SGB) for Depression

By Kimberly Mercille • May 27, 2025
Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option. What is a Stellate Ganglion Block (SGB)? What is the Stellate Ganglion? The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion. The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction. When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress. How Does Stellate Ganglion Block Work? Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment. SGB is typically performed using ultrasound guidance . The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety. How Does Stellate Ganglion Block Work for Depression? Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain. Excessive cortisol can lead to: Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation. Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells. Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour. Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening. SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience. Evidence Supporting SGB for Depression To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small. Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD , participants reported significantly lower scores of depression following treatment. Who May Benefit from SGB for Depression? SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety. Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies. Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include: Recent myocardial infarction Coagulopathy or anticoagulant therapy Glaucoma Pre-existing contralateral phrenic nerve palsy Severe emphysema Cardiac conduction block Potential Risks and Side Effects of SGB Common Side Effects Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include: Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness. Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur. Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure. Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived. Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure. Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily. Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions. Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case. SGB for Depression in Illinois If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.

SGB for Long COVID: Can a Nerve Block Help Ease Symptoms?

By Matt Rodriguez • May 7, 2025
Long COVID is a condition in which symptoms–such as brain fog, fatigue, and shortness of breath—persist for months after a COVID-19 infection. Researchers are still working to understand why this happens and how to treat it. One potential therapy being explored is the stellate ganglion block (SGB) , a procedure that numbs a cluster of nerves in the neck. In the article, we’ll explore the science behind SGB and long COVID and the evidence supporting its use.

Insurance-Backed Options for Depression Treatment in Illinois

By Matt Rodriguez • April 1, 2025
Finding effective depression treatment can be challenging, especially when cost and insurance coverage add to the stress. Fortunately, for individuals in Illinois, several advanced, insurance-backed options are available beyond traditional antidepressants and therapy. This article explores innovative treatments for depression that are available at our Albany Clinic in Carbondale. Addressing the Need for Affordable Depression Relief in Illinois Depression remains a significant public health concern in Illinois. In 2023, data showed that 18.1% of all adults in the state had a doctor's diagnosis of a depressive disorder . Traditional first-line treatments for depression include medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these are not universally effective; approximately one-third of patients are treatment-resistant. Even when these medications do work, they often take a long time to produce noticeable improvements, and unpleasant side effects can deter their use. Talk therapies , such as cognitive behavioral therapy (CBT) and psychodynamic therapy, are also strongly recommended. These treatments can have hugely beneficial effects, but it can require a lot of time commitment for results to show. Moreover, not all therapists accept insurance–especially for those practicing more specialized forms–making the treatment inaccessible for many. Spravato (Esketamine) for Depression What is Spravato, and how does it work? Spravato is an FDA-approved nasal spray that contains esketamine, a derivative of ketamine. Like ketamine, esketamine treats depression by interacting with NMDA receptors , proteins that play a key role in learning and memory. This interaction triggers several neurological processes, including neuroplasticity —the strengthening and forming of connections between nerve cells. Enhanced plasticity may improve the function of nerve circuits responsible for mood regulation, increasing overall well-being. A typical Spravato treatment involves sessions administered under medical supervision, starting with twice-weekly doses and then tapering as appropriate. Whereas antidepressants typically take around four weeks to show an effect, Spravato can have rapid action at alleviating symptoms. A study found that Spravato significantly reduced depression symptoms compared to a placebo drug within just 24 hours of administration. Does Insurance cover Spravato? Due to its FDA approval, Spravato is covered by most major insurance plans in Illinois, including Medicare and Medicaid. However, only patients with a formal diagnosis of treatment-resistant depression (TRD) or major depressive disorder with suicidal ideation (MDSI) are eligible for the treatment. While the medication is usually covered by insurance, patients may still have out-of-pocket costs , including copays , deductibles , and pre-treatment medical evaluations . Your exact expenses will depend on your specific insurance plan. At the Albany Clinic, we’re here to help you understand your costs and maximize your coverage. Transcranial Magnetic Stimulation (TMS) Therapy What is TMS, and how does it work? TMS therapy is a noninvasive procedure that uses magnetic fields to stimulate underactive regions of the brain associated with mood regulation. In depression, TMS targets the dorsolateral prefrontal cortex (DLPFC) , which is often less active in individuals with the condition. TMS therapy works by: Inducing electrical activity in neurons , prompting the release of neurotransmitters involved in mood and motivation. Increasing the activity of neural circuits responsible for mood regulation. Enhancing neuroplasticity , potentially “re-wiring” nerve circuits associated with unhealthy thinking and behavior. The treatment protocol typically consists of daily sessions over several weeks. Each session lasts about 20-40 minutes, during which patients remain awake and alert. Does insurance cover TMS? Since TMS therapy is FDA-approved, some major insurance providers in Illinois cover costs, but unfortunately, the state’s Medicaid does not. If you're considering TMS, check with your insurance provider to see if your plan includes coverage, as eligibility and benefits vary. At the Albany Clinic, we're here to help clarify details and explore options to make treatment more affordable. IV Ketamine Infusion Therapy What is an IV ketamine infusion and how does it work? IV ketamine infusion therapy involves administering ketamine intravenously at sub-anesthetic doses . This approach has shown rapid and robust antidepressant effects, especially in individuals with treatment-resistant depression. IV ketamine shares the same mechanism as Spravato but tends to have more rapid-acting effects. A standard course includes multiple infusions over a set period, with each session lasting approximately one hour. Does insurance cover IV ketamine? Unlike Spravato and TMS, IV ketamine infusion therapy is not FDA-approved for depression treatment and instead is used “ off-label .” This means most insurance plans don’t accept ketamine, and coverage is limited. However, some insurance companies may reimburse some of the treatment costs, such as the evaluation and management part. At the Albany Clinic, we’ll provide you with all the documentation to submit a claim to your insurance provider, but full payment is required before each procedure. Navigating Insurance for Depression Treatment Understanding insurance coverage for depression treatments can be complex. Here are steps to help streamline the process: Verify Coverage : Contact your insurance provider to inquire about treatment coverage specifics. Some insurers require a history of treatment failures with traditional antidepressants before approving coverage for these advanced therapies. Obtain Pre-Authorization : Many insurers require pre-authorization for certain treatments. Ensure all necessary approvals are secured before initiating therapy. The Albany Clinic's administrative team can assist in submitting pre-authorization requests. Understand Financial Responsibilities : Clarify any co-pays, deductibles, or out-of-pocket expenses associated with your treatment plan. Consult Our Team : The Albany Clinic's administrative staff is experienced in navigating insurance processes and can assist you in understanding and managing the financial aspects of your treatment. We also provide financial counseling to help patients explore payment plans and reimbursement options. Going Forward Navigating insurance for depression treatment can be complex, but you don’t have to do it alone. At The Albany Clinic , we’re dedicated to helping patients access effective, insurance-backed treatments while minimizing out-of-pocket costs. Contact us today to learn more about your options and take the next step toward relief.