Exploring the Impact and Intersection of Childhood Trauma on Fibromyalgia

Christina is studying the Signs and Symptoms book.

I wrote this paper for one of my psychology classes a few years ago. I received an A for this literary review. What is missing from this is the reality of living in daily pain on a scale. The other piece that I’m noticing people are missing when we look at chronic conditions is faith. I have suffered a lot in my life; that is not a victim mentality, it is a hard and difficult truth. That suffering led me to a deepening relationship with Jesus. I wouldn’t be capable of helping so many women with chronic conditions while living with fibromyalgia and CFS if it weren’t for my faith. My ACE score is an 8. That is trauma that happened before I turned 18. That doesn’t include what was stacked from being a military spouse and marrying into a dysfunctional family. As if my own family wasn’t dysfunctional enough.

After doing all of this research, I believe that there is a deep connection between pain conditions such as Fibromyalgia and the neurobiology of trauma. At the time I submitted this paper, scientists were on the cusp of discovering two things that would change outcomes for those diagnosed with FM. Scientists are close to identifying a biomarker to test for FM, and they are close to establishing that FM is, in fact, an autoimmune condition.

After doing all of this research, I believe that there is a deep connection between pain conditions such as Fibromyalgia and the neurobiology of trauma.

Childhood trauma has long been recognized for its lasting impact on mental health and adverse health outcomes. Growing evidence indicates that it also significantly influences physical health outcomes, such as chronic pain and fibromyalgia (FM) (Antoniou et al., 2023). This research explores how adverse childhood experiences (ACEs), which encompass emotional, psychological, physical, and sexual abuse, as well as neglect, may contribute to the development and severity of chronic pain and fibromyalgia symptoms in adults. Fibromyalgia is a condition known for its widespread pain and fatigue, and it is without a definitive etiology. Fibromyalgia is a nociplastic pain that arises from the altered processing of pain signals in the central nervous system. FM patients often feel allodynia and hyperalgesia and have tender points. The pain can feel like burning, throbbing, aching, stabbing, or shooting.  Making FM challenging to diagnose, manage, and treat effectively (Dizner-Golab et al., 2023). However, studies suggest a substantial overlap between childhood trauma and adult onset of FM. The creation of a spectrum of severity based on childhood adverse events could provide information that leads to improved diagnosis times and treatment options. The options would be based on the section of not having FM to mild, moderate, or severe cases.  Emphasizing the potential for trauma-informed interventions and specific interdisciplinary treatments to enhance patient outcomes. As rates of ACEs continue to be linked to a variety of chronic health issues, understanding the childhood trauma-FM connection may hold the key to reducing the burden and severity of FM for countless individuals.

Fibromyalgia is a nociplastic pain that arises from the altered processing of pain signals in the central nervous system. 

Decades of research have demonstrated a link between ACEs and several adult health and mental health issues, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), anxiety, and chronic pain (Gardoki-Souto et al., 2022; López-López et al., 2023). Individuals with chronic pain report higher instances of PTSD, with prevalence rates reaching up to 57% compared to 2–9% in the general population (Siqveland et al., 2017). Similarly, conditions like major depressive disorder (MDD) and anxiety often coexist with chronic pain, forming a complex correlation that exacerbates symptom severity (Antoniou et al., 2023). Key symptoms of MDD include persistent depression or low mood, loss of interest or pleasure in most activities, significant changes in appetite, insomnia or excessive sleeping, difficulty concentrating or making decisions, and at times, concurrent thoughts of death or suicide (American Psychiatric Association [APA], 2022). For example, in the UK, a study shows that approximately half of people diagnosed with major depressive disorder (MDD) also experience chronic pain. These findings support the idea that trauma, particularly early-life adversity, plays a critical role in FM symptomatology and that trauma’s lasting impact extends far beyond psychological consequences, profoundly affecting the body’s pain-processing pathways (Cohen et al., 2002; Yavne et al., 2018). Understanding the statistical prevalence and significance of comorbid mental health mood disorders, depending on the severity of ACEs and FM, also has the potential to involve interdisciplinary treatment options. 

 Given the shared risk factors between PTSD and chronic pain conditions like FM, it is likely that unresolved trauma in childhood disrupts emotional regulation processes, increasing vulnerability to both psychological and physical pain later in life.

Fibromyalgia patients exhibit higher rates of adverse childhood experiences than the general population, with up to 84% reporting trauma before FM onset (Gardoki-Souto et al., 2022). Studies indicate that childhood trauma may predispose individuals to FM through mechanisms of central sensitization, where the nervous system becomes hypersensitive, leading to heightened pain perception (Peres et al., 2009; Yavne et al., 2018). With this new understanding of FM through recent research, neurologists and rheumatologists are now diagnosing people with FM. In addition, over half of people with FM meet clinical or subclinical criteria for PTSD, highlighting the significant overlap between these conditions (Peres et al., 2009). Given the shared risk factors between PTSD and chronic pain conditions like FM, it is likely that unresolved trauma in childhood disrupts emotional regulation processes, increasing vulnerability to both psychological and physical pain later in life.

Trauma's cognitive and emotional impact on FM patients is illustrated by the prevalence of early maladaptive schemas (EMSs), which are patterns of negative beliefs that develop from childhood adversity and shape responses to stress (López-López et al., 2023). Individuals with FM tend to score higher in EMSs related to mistrust, emotional deprivation, and approval-seeking, which in turn intensify psychological symptoms such as anxiety and depression (López-López et al., 2023)—suggesting that addressing these maladaptive cognitive patterns could be beneficial in managing FM and reducing associated mental health symptoms. Evidence also indicates that trauma-focused therapies, such as emotional exposure therapy and cognitive behavioral therapy (CBT), are effective in alleviating psychological symptoms of trauma, even if their effect on physical pain remains limited (Lumley et al., 2008). Thus, multidimensional treatment approaches incorporating trauma care could potentially improve FM patient outcomes by addressing both psychological and physical needs. The use of a spectrum of FM has the potential to improve clinical outcomes by reducing diagnostic times and expanding treatment options.

Despite the progress in understanding the trauma-FM relationship, current research has limitations. Many studies rely on self-reported trauma histories, which may introduce recall bias and often lack control groups, reducing the generalizability of findings (Gardoki-Souto et al., 2022; Lumley et al., 2008). Additionally, the cross-sectional designs commonly used in trauma-FM research prevent conclusions about causality, making it difficult to establish whether trauma directly leads to FM or merely exacerbates it in predisposed individuals (Yavne et al., 2018). To address these gaps, future research must employ longitudinal methods and controlled designs to delineate better the pathways through which ACEs contribute to FM. Integrating trauma-informed approaches in FM care may offer promising avenues for mitigating the severity of both psychological and physical symptoms.

This study proposes that the severity of childhood trauma will predict greater severity of FM symptoms, as measured by validated scales assessing pain intensity and psychological distress, compared to individuals without such trauma histories. This research aims to identify associations between ACEs and FM severity through a cross-sectional survey using tools such as the Adverse Childhood Experiences (ACEs) scale, the Visual Analog Scale (VAS), and the Fibromyalgia Impact Questionnaire (FIQ). By examining these relationships, the study will offer insights into how interdisciplinary trauma-informed care could be crucial in FM management and improve overall patient well-being by creating a spectrum of the condition.

I hope this paper leads to a legitimate study that treats FM with the same parameters as other autoimmune conditions. This would help distinguish the symptoms and severity of pain, which could later inform holistic protocols to improve outcomes.

What I do know for certain from personal experience is that living with FM is exhausting. Mold can exacerbate the pain. Allopathic medicine doesn’t know what to do with people who have FM. The pain management clinic has been my best friend.

Christina

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