By Pat Anson, PNN Editor

People who experienced neglect or physical, sexual or emotional abuse as children are significantly more likely to have chronic pain as adults, according to a large new analysis. Individuals who had adverse childhood experiences (ACEs) were 45% more likely to report chronic pain in adulthood than those who did not have childhood trauma.

“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 author André Bussières, PhD, an Assistant Professor at the School of Physical & Occupational Therapy at McGill University. 
 
“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.”  

Bussières and his colleagues reviewed 75 years of research involving over 826,000 people. Their findings, published in the peer-reviewed journal European Journal of Psychotraumatology, adds to the growing body of evidence showing an association between ACEs and chronic pain.

ACEs may affect a child directly through physical, sexual or emotional abuse, or neglect – or indirectly through exposure to environmental factors like domestic violence, living with substance abuse, or parental loss.

Physical abuse during childhood had the strongest association with chronic pain and pain-related disability. The odds of having chronic pain were also higher if a person experienced multiple ACEs, either alone or combination with indirect ACEs. The research does not prove that ACEs cause chronic pain, only that there’s an association.

“Our findings suggest ACE exposure is associated with the most common and costly chronic pain conditions, including back and neck pain and other MSDs (musculoskeletal disorders), which account for the highest total health care spending compared to other health conditions,” researchers said.

“People with ACEs tend to have a higher chronic disease burden, barriers to treatment engagement, and greater health care utilization in adulthood. Adult patients exposed to ACEs may not be achieving optimal health outcomes due to the physiological and psychological effects of toxic stress. While the relative contributions of these mechanisms are not yet well understood, emerging evidence links ACEs to changes in genetic expressions that affect structural and functional changes in the brain and clinical phenomena in adulthood.”

Still unclear is the role that ACEs play in specific pain-related conditions. Previous studies have linked childhood trauma to an increased risk of headache disorders, fibromyalgia and lupus, as well as mood and sleep problems.