How Your Childhood Influences Your Pain

in Blog May 31, 2018

…Negative Emotions, While Not the Only Cause, Make Pain More Likely

Have you ever thought about seeing a counselor for your neck or back pain? After reading this you will!

My mother experienced many unexplained symptoms while I was growing up, including widespread pain. Unfortunately in the 90s, doctors had no idea what she had and did not take her eventual diagnosis of fibromyalgia seriously- a disorder characterized by chronic pain due to hypersensitivity of nerves. This led to an unhealthy habit in me (that persists today) to dismiss any pain I have, since the prevailing notion of the time was that it’s not real, and it’s all in your head. Then after working on my own health and Hashimoto’s and resolving many of my symptoms except for muscular pain, I finally saw a rheumatologist. She took a history, looked at labs, and did the tender point test. Of the 18, I believe I had 14 tender points. Above 5 is considered high. Eek. I walked out with a fibromyalgia diagnosis. I was stunned.

How could this happen? I had worked so meticulously on my health. So I dove into the scientific literature to glean some insight. And I was amazed at what I found. My dysfunctional childhood, mixed with long-term unresolved injuries and a relentless pace in life, was a perfect storm to create a hypersensitive nervous system. This means the pain is both psychological as well as physical. Both have to be addressed for healing to occur.

Did you know that those who have suffered emotional abuse in childhood are more likely to struggle with chronic pain in adulthood than those who suffered physical abuse? (And of course those who were never abused have the best health of them all). This was confirmed during the landmark ACE study of 17,000 Californians, which showed that those who suffered at least six of the ten measured negative childhood experiences died a whopping TWENTY years earlier on average than those who experienced none. Those who experienced 4 or more had a 3 times greater risk of poor health. This study made it clear: the emotional aftermath of abuse, neglect, or a dysfunctional home leads to deterioration of physical well-being.

Confirming this finding, a study of 289 people were given a stress questionnaire. Those with higher scores were more likely to have more tender points upon examination. Interestingly, those with the highest number of tender points were SEVEN times more likely to have experienced childhood abuse.

tender photo

More studies elucidate that stress precedes the pain and is therefore a root cause. A large study of 1638 individuals in the UK found that those with more stress were about twice as likely to develop chronic low back pain without any known cause. They concluded that 16% of new episodes of back pain was due to psychological factors. Another study showed that patients with fibromyalgia were significantly more likely to experience childhood adversity than those with medically explained pain.

The crazy thing is, you are more likely to have chronic pain if you’ve had high stress than if you’ve been physically injured. A British study followed 7,571 individuals for 45 years. Those who had surgeries were no more likely to have chronic pain. However, those who were hospitalized after an accident were 1.5 times more likely to develop chronic pain, those with financial hardship were 1.6x more likely, and those who experienced maternal death were 2.0x more likely. The emotional traumas had a greater impact than the physical traumas on pain.

stress photo

Since fibromyalgia (FM) is an extreme example, researchers have used it as a way to study the triggers and mediators of pain. One study found that being bullied at work or a high workload led to a 2-4x greater risk of developing FM. In addition, occurrence of PTSD is 3x more likely.

One biological explanation is changes to the neuroendocrine system. FM patients have a disrupted cortisol curve. Cortisol gives us resiliency to stressors, and causes a suppression of the immune system. It’s supposed to be high in the morning and drop throughout the day. FM patients often have a flattened curve, not rising in response to the stress of awakening and not falling near the onset of sleep. And guess what? Those with more childhood trauma had lower cortisol. What do doctors give us when we’ve got pain that won’t go away? A steroid shot or cream, which is…cortisol! See the connections?

Does this mean we are doomed to pain because we can’t go back and change our childhood? Absolutely not. It is not uncommon for people to be able to resolve low back pain, chronic neck pain, headaches, or fibromyalgia. The trick is addressing all the root causes, including the psychological factors. Methods such as Tai Chi, mindfulness, meditation, acupuncture, Cognitive Behavioral Therapy, and EMDR therapy can all help just as much as sleep, an anti-inflammatory diet, and regular exercise.

meditation photo

References:
Am J Prev Med. 1998 May;14(4):245-58.
Arthritis Rheum. 1999 Jul;42(7):1397-404.
Spine. 01 Dec 1995, 20(24):2731-2737.
Eur J Pain. 2003;7(2):113-9.
Pain. 2009 May;143(1-2):92-6.
Curr Rheumatol Rep. 2005 Oct;7(5):365-70.
Psychoneuroendocrinology. 2006 Apr;31(3):312-24.

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