Mental health: Can physical pain be rooted in trauma?

Maří Bartos lived with crippling lower back pain for years, never thinking that it was an indication of a deep, psychological trauma. “It felt like a constant dull ache that would sometimes escalate into sharp, stabbing pains,” said the 39-year-old architect living in Dubai. “There were times when the pain was so severe that it limited my mobility and interfered with my ability to work.”

Bartos initially sought traditional medical diagnosis and treatment, believing that her symptoms were solely rooted in a physical ailment or injury. She thought her pain was related to the nature of her work, which often involved long hours of sitting or standing in uncomfortable positions.

“Seeking medical help was a frustrating experience,” explained the Czech national who has lived in the UAE for six years. “Despite undergoing numerous tests and consultations, doctors were unable to pinpoint a specific cause for my pain. While there were some degenerative changes in my spine, they didn’t seem significant enough to justify the intensity of my symptoms. And all the medication I was taking added to my suffering — I got frequent stomach aches due to the side effects of painkillers I was taking. I felt unheard and misunderstood, which only added to my anxiety and despair.”

It was only by chance that Bartos’ healing journey would begin when she came across information about pain psychotherapy online. She discovered the work of Anna Marków, a pain psychologist in Dubai, who specialises in exploring the mind-body connection and how emotional stress can manifest as physical pain. “It was a leap of faith, but I was desperate for relief and willing to explore alternative avenues,” Bartos said.

Pain, both seen and unseen, shapes our existence profoundly. Yet, while physical injuries garner immediate attention, the quieter agony of psychological trauma that manifests into physical pain often goes unnoticed.

“When you have been diagnosed with chronic pain, it means that you’ve had pain for at least three months or more. It affects your mood, your ability to be present, and your quality of life,” explained Marków. “Many patients feel excluded from life — you are unable to continue your work, your hobbies, and you feel like you’re a burden to your family and friends. Unfortunately, depression and anxiety disorders are highly linked with chronic pain.”

Chronic pain can be a result of physical trauma to the body that leads to emotional suffering as the body heals. Alternatively, the opposite can often be a cause of chronic pain as well: emotional suffering that causes physical pain, without the presence of physical damage to the body.

“When you have sudden pains out of nowhere, or experience life-long chronic pain not caused by obvious injury, it can be rooted in a dysregulated nervous system,” Marków said. “Our nervous system’s job is to keep us safe. Something may have happened in your past and your nervous system may suppress your emotions because it lacked the ability to regulate itself in the moment. That suppression results in unaddressed trauma, and, because we only have one nervous system, if other situations trigger those unaddressed emotions, they can result in extreme emotional suffering that eventually manifests into physical pain symptoms seemingly without a root cause.”

Unfortunately, what this means for many is a struggle for empathy, understanding and proper care in traditional healthcare systems. “There’s a lot of gaslighting for sufferers of chronic pain rooted in unaddressed trauma. Traditional doctors may be flippant, suggesting the patient simply ‘stops stressing’ or questioning the reality of a person’s experience with pain,” Marków said.