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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In-Clinic vs. At-Home Ketamine Therapy: What’s Best for Your Mental Health?

By Kimberly Mercille • July 9, 2025
As ketamine therapy becomes increasingly popular for treating mental health conditions like depression and PTSD, more people are exploring their options. At-home ketamine therapy gained traction during the pandemic for its convenience, but without medical supervision, this approach may come with elevated risks. In this article, we’ll explore some of the key differences and pros and cons of in-clinic versus at-home ketamine therapy. What Is In-Clinic Ketamine Therapy? IV Ketamine Treatment In-clinic ketamine therapy involves receiving treatment at a licensed medical facility, such as The Albany Clinic , where professionals monitor and administer the medication under strict protocols. This ensures your safety, especially during your initial sessions. At The Albany Clinic, we specialize in intravenous (IV) ketamine infusion therapy , which has been most well-researched when it comes to treating mental health disorders. IV ketamine bypasses the digestive system, delivering the medication directly into the bloodstream. IV ketamine can help relieve symptoms of various mental health disorders, including depression , anxiety , post-traumatic stress disorder (PTSD) , and more. During an infusion at our clinic, you’ll rest in a calm, controlled environment while ketamine is delivered into a vein through a catheter. Our trained staff will closely monitor your vital signs and mental state throughout the session, adjusting the dose of ketamine if needed. We’ll observe you after treatment to ensure any side effects are managed promptly and effectively. Spravato We also offer Spravato (esketamine) at our clinic, a nasal spray based on ketamine. Unlike other forms of ketamine treatment, Spravato is approved by the FDA and is specifically for adults with treatment-resistant depression or major depressive disorder with suicidal thoughts . Spravato is only approved for in-clinic use under professional supervision and cannot be administered at home, making clinical oversight a legal and medical necessity for this treatment option. During a Spravato session, you’ll self-administer the medication under the supervision of our medical staff. We’ll then closely monitor you for a couple of hours to ensure you’re safe and all side effects have subsided before leaving. What Is At-Home Ketamine Therapy? At-home ketamine therapy allows patients to self-administer the ketamine, typically in the form of lozenges or nasal sprays, delivered via mail. While this option offers flexibility, it usually involves minimal supervision , often limited to virtual check-ins with healthcare providers. Some at-home providers offer optional video support during sessions, but this is not always the case. Patients are largely responsible for monitoring their own physical and emotional reactions, without the benefit of immediate medical intervention if adverse effects occur. At-home treatment often includes supplementary materials , such as guided meditations or journaling tools. However, the lack of real-time clinical oversight makes this option less ideal for those with complex or severe mental health needs. Safety Considerations: In-Clinic vs. At-Home While ketamine therapy is considered safe for most patients, it does come with potential physical and psychological side effects , including: Physical Risks: Elevated blood pressure or heart rate Nausea or vomiting Sedation or dizziness Impaired coordination Rare allergic reactions Psychological Risks: Hallucinations or dissociation Temporary confusion or anxiety Emotional vulnerability during treatment Risk of misuse or dependency The FDA has issued warnings about at-home ketamine use due to its potential for abuse and lack of medical supervision . Without proper monitoring, the risk of addiction and long-term complications, such as bladder damage and cognitive decline, may increase. Key Differences Between In-Clinic and At-Home Ketamine Therapy

A Guide to IV Ketamine

By Matt Rodriguez • July 8, 2025
Intravenous (IV) ketamine has emerged as a promising option for individuals struggling with treatment-resistant depression and other hard-to-treat mental health conditions. Ketamine was originally developed as an anesthetic, but is now being used in controlled medical settings to deliver rapid relief when traditional therapies fall short. This guide explores the history, science, benefits, and practical considerations of IV ketamine therapy and what you can expect from treatment at The Albany Clinic.

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.