Chronic pain and posttraumatic stress disorder (PTSD) are often overlooked. PTSD may not be diagnosed because the health care provider, patient, and family may be focusing on the pain disorder. There have been instances where the patient's level of disability may be attributed solely to pain. Often referred to as "mutually maintaining" conditions, the presence of both PTSD and chronic pain can increase the symptom severity of either condition. For example, individuals with chronic pain may not participate in an activity because they fear painavoiding activity can lead to physical deconditioning and greater disability and more pain over time.
Treatment for PTSD usually focuses on providing education about the disorder. The information may include specifically addressing how fears and avoidance of the trauma may serve to maintain the symptoms and decrease a patient's ability to function. Furthermore, the education may include discussing how pain may serve as a trigger or reminder of the pain and increase a patient's fear and avoidance and thereby increase a patient's disability and pain.