Chronic Pain and Trauma: Why Pain Persists After the Body Has Healed

Written by Roland Bal

Chronic pain is rampant after accidents, surgery, and trauma. Chronic pain has similar symptoms for various incidents but the common denominator is the element of post-traumatic stress.

Traffic or falling accidents seem straightforward. A spleen might be torn, a concussion could occur, bones could be broken. What if emergency care and rehabilitation patches you up and you are still suffering from inexplicable chronic joint pains, migraines, fatigue, restless legs?

What do you do when doctors and specialists give you their "all clear" with their medical checks and turn a blind ear and eye to your complaints of pain? Furthermore, they might even tell you that you are imagining it?

With all the knowledge available on trauma this, sadly, is still a very common response by the medical system. The lack of understanding by "specialists" is sometimes even more disheartening than the accident itself.

Why Pain Stays After the Injury Heals

The reason pain persists long after the physical injury has healed is that the nervous system has not returned to its pre-trauma state. The tissues may have repaired, the bones may have knitted, the surgical wound may have closed — but the body is still bracing, still on alert, still holding the activation that was mounted at the time of the event. That held activation creates real, measurable tension in muscles, fascia, and organs. It is not imagined. It is the body continuing to respond to a threat that is no longer present.

This is why chronic pain after trauma so often shows up in areas that were never injured. The neck tightens because the brain stem is still locked in fight-or-flight. The jaw clenches because the body is holding what was never expressed — the scream, the anger, the shock. The digestion disrupts because the vagus nerve, which regulates gut function, is suppressed when the nervous system is stuck on high alert. These are not separate conditions. They are downstream effects of one unresolved event.

A Case Study: Chronic Pain After a Car Accident

I have heard similar stories so many times when working with people who have had a car or falling accident and are left with chronic pain and fatigue. Fortunately, in most cases, I am able to help them move forward and reduce a good percentage of their pain symptoms or resolve their condition.

Let's take a closer look at a case history to see what is going on and find out why we still suffer long after the event of an accident:

James was in a minor car accident where the car in front of his didn't respect the red stoplight in time. James hit the car from the side and was thrown forward, hitting the steering wheel and then falling to the ground on his left side. After hitting the ground, his first reaction was to get up and make sure the driver hadn't escaped, but due to shock and pain in his left leg, he fell to the ground again. He did not speak to the other driver as the incident was further handled by the police who arrived quickly on the scene.

Two years after the incident James still suffers from indigestion, tight neck and jaw chronic pain that give him a lot of trouble with concentration, in sitting for extended periods of time, and basically preoccupy him continuously. His physical injuries from the fall itself — left knee and lower back pains — have healed properly. His doctor and traumatologist dismiss his further complaints of pain, simply leaving him to his own devices.

The Nervous System Response Behind the Pain

When we are bracing ourselves in anticipation of an accident or a similar situation, our body releases a lot of nor/adrenaline to activate the body-mind in order to fight or flight. When fight or flight is not possible, as is the case with a sudden impact, your body-mind goes into a "freeze" response immediately.

A major player in the brain that regulates the fight-flight-freeze mechanism is the pons and medulla — the brain stem — situated in the back of the head just above the neck. When this activation stays on "ON" it chronically tenses up the muscles in the neck, jaws and affects the vagus nerve that regulates digestion.

Furthermore, the emotion that is present during and after the accident is often tied up with the activation. In James' case, he got really anxious that the driver might escape, as well as being angry with him for causing the accident. That anxiety and anger did not get expressed or discharged — they stayed locked in his body alongside the physical bracing, compounding the pain pattern.

What Resolution Looks Like

In the session, we took James back to the accident. Within a safe and contained setting, we allowed him to speak out and feel his activation, fear, nervousness and above all, his anger. Helping him to feel his nervousness and activation released the tensions in his solar plexus. Getting him to vocalize his anger helped him to complete his fight-flight mechanism. Furthermore, it helped him release his neck and jaw muscles and related pons-medulla brain structures. Making the link within the accident as an action shared, the emotion and body responses helped him to process the work on a cognitive level.

This is the pattern I see repeatedly in my practice. The pain is not a mystery — it is the nervous system holding an incomplete survival response. The body mounted energy to fight or flee, that energy was not discharged, and now it sits in the tissues as chronic tension, inflammation, and pain. The work is to help the body complete what it could not complete at the time.

It does not matter whether the original event was a car accident, a surgery, a fall, or something from early childhood. The mechanism is the same. The nervous system locked into a protective response, the response was never resolved, and the body continues to pay the price in pain, fatigue, and restricted movement. When the held activation is finally discharged — carefully, at the body's own pace — the pain that no medical scan could explain begins to resolve. Not because something was imagined, but because something was finally completed.