How processing your trauma can reduce pain and inflammation

My first experience of the trauma therapy eye-movement desensitisation and reprocessing (EMDR) was when I was training to be an EMDR therapist. During the training practice I found myself transported back to my childhood home, milliseconds equating to whole years of lived experience, as my brain rapidly considered and contextualised things. I found myself recognising realities I could never have consciously conjured. The recognition of which made me feel much different. Lighter, freer, less oppressed. It was a revelation – the whole experience.

If you're a long-time newsletter subscriber or you have read the previous blogs, you'll be familiar with the effects of stress and trauma on the brain, the nervous system and the immune system. In a nutshell, it is well-established that your brain processing and even structure can be changed by chronic or extreme stress and these changes lead to changes in how your nervous system works, how your neuroendocrine (hormonal) systems work and what is happening in your immune system (1–3). There are so many complexities in this inter-tangled web of communication systems, but what we can clearly observe, is that these changes also change sensory experiences including pain.

Pain is the combination (generally) of two broad things: signalling from nerves at the site of pain and calculations made in the brain. This is the pain equation. However, research has shown that sometimes the brain keeps calculating pain long after the nerves are firing (4). This is why injury can result in chronic pain, even once the injury is healed. There are lots of names for this type of pain including neuroplastic pain, or neuropathic pain. The fault in the brain calculation is often due to multiple strands of 'data' clouding clarity in the brain. Data such as emotion; how much threat your brain is detecting based on emotion and threat processing centres in the brain like the amygdala, but also based on how your autonomic nervous system is generally behaving (4,5). Erratic responses and dysregulation can prime the brain to amplify pain (1).

Previously I've written about some of the ways chronic or extreme stress changes your neurobiology, changing brain activity, changing hormonal balances, releasing and later suppressing cortisol, affecting nervous system activity. Well, all of those changes, can impact how pain is processed. In one fascinating animal study (which has its place in understanding neurobiology), researchers found that chronic stress caused inflammation in the spinal cord, making nerves residing there 'jumpy' making the animals more sensitive to touch and pain (1). In the same study they found that this stress contributed to anxiety, which didn't impact the spinal inflammation but amplified the sensory experience of pain, making it last longer and feel more severe. Previous studies demonstrating overlaps in where the brain processes pain and emotion can go some way to explain this physical change in pain (6).

When you experience trauma, your brain's ability to contextualise those memories and regulate the emotional impact, is disrupted (8). That means that the experience can sit in the periphery, out of consciousness, yet still affecting your mood and how you feel day to day. This is reflected in the comments I hear from people after EMDR processing, talking about feeling like a weight has been lifted, or things feel clearer or brighter. Your brain has had the opportunity to consolidate a lot of messy, threatening stuff that has been splattered all of your emotion, sensory and cognitive processing regions of the brain. When you process the past, it can alleviate a huge emotional burden, improving emotion regulation and alleviating a lot of ongoing stress (9). Studies have shown changed default emotion brain circuitry after the trauma processing therapy, EMDR (10).

Eye movement desensitisation and reprocessing (EMDR) is a therapeutic process originally developed for trauma in the context of PTSD. However, since its origin it has been adapted and studied in a variety of contexts including chronic pain. Although research is still in its infancy to some degree, the results are compelling.

The bottom line: Unprocessed trauma creates ongoing stress in your nervous system that can amplify pain signals and maintain inflammation - even when there's no current tissue damage. Research shows trauma therapy like EMDR can significantly reduce chronic pain by helping your brain differentiate between past threatening experiences and present reality. Studies demonstrate up to 86% complete pain recovery in some conditions, with measurable changes in brain circuitry after trauma processing. Your pain is real, but trauma processing offers a evidence-based pathway to help your brain turn down the volume.