Chronic pain and posttraumatic stress disorder (PTSD) are often overlooked. PTSD may notbe diagnosed because the health care provider, patient, and family may be focusing on the paindisorder. There have been instances where the patient's level of disability may be attributedsolely to pain. Often referred to as "mutually maintaining" conditions, the presence of bothPTSD 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 pain—avoidingactivity 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 informationmay include specifically addressing how fears and avoidance of the trauma may serveto maintain the symptoms and decrease a patient's ability to function. Furthermore, the educationmay include discussing how pain may serve as a trigger or reminder of the pain andincrease a patient's fear and avoidance and thereby increase a patient's disability and pain.