Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review

Pain Med. 2017 Apr 1;18(4):711-735. doi: 10.1093/pm/pnw065.


Objectives: The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD.

Methods: Of 477 studies, 40 fulfilled the inclusion/exclusion criteria of this review and were grouped according to the type of CP. The reported prevalence of PTSD for each grouping was determined by aggregating all the patients in all the studies in that group. Additionally all patients in all groupings were combined. Percentage of studies that had found an association between CP and PTSD was determined. The consistency of the evidence represented by the percentage of studies finding an association was rated according to the Agency for Health Care Policy and Research guidelines.

Results: Grouping PTSD prevalence differed ranging from a low of 0.69% for chronic low back pain to a high of 50.1% in veterans. Prevalence in the general population with CP was 9.8%. Of 19 studies, 16 had found an association between CP and PTSD (84.2%) generating an A consistency rating (consistent multiple studies). Three of the groupings had an A or B (generally consistent) rating. The veterans grouping received a C (finding inconsistent) rating.

Conclusion: The results of this systematic review confirmed the hypotheses of this review.

Keywords: Chronic Pain; Chronic Pain Patients; Motor Vehicle Accidents; Post-Traumatic Stress Disorder (PTSD); Veterans Prevalence PTSD Chronic Low Back Pain Headache Facial Pain Pelvic Pain.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bias
  • Chronic Pain / diagnosis*
  • Chronic Pain / epidemiology*
  • Chronic Pain / psychology
  • Comorbidity
  • Evidence-Based Medicine / statistics & numerical data*
  • Female
  • Humans
  • Internationality
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Pain Measurement / statistics & numerical data*
  • Prevalence
  • Reproducibility of Results
  • Risk Factors
  • Self Report / statistics & numerical data*
  • Sensitivity and Specificity
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Young Adult