When the Body Keeps the Score: Trauma, Chronic Pain, and the Path Toward Healing
Based on a Conversation with Kaylee Richardson
There are moments in life that break through our normal categories.
A house fire. A violent relationship. A childhood marked by neglect. A car accident. A war zone. A season of prolonged fear, instability, or loss. Sometimes the event passes, but the person does not feel as though they have truly come out of it. The body stays tense. The chest stays heavy. Sleep changes. Pain lingers. Anxiety rises. Concentration fades. The nervous system seems unable to settle.
This is one reason trauma is so important to understand. Not because it is trendy language, but because it is real. Trauma does not only affect thoughts. It can shape the body, relationships, emotions, and physical symptoms in ways many people do not immediately recognize.
In both mental health and physical medicine, there is a growing awareness that healing often requires more than symptom management. It requires understanding the whole person.
Trauma is not just the event
One of the most important distinctions in trauma work is that trauma is not simply the event itself. Two people can walk through the same crisis and emerge with very different responses. One may grieve deeply but process the event in a way that allows healing to take place. Another may remain stuck in a loop of fear, vigilance, shame, or overwhelm long after the danger has passed.
That distinction matters.
A traumatic event is what happened. Trauma is what happened in the brain and body afterward.
This helps explain why some experiences remain “alive” in a person long after the event is over. The body reacts as if the threat is still present. The mind replays it. Certain triggers reignite it. A smell, a sound, a place, a memory, a season, or even a tone of voice can provoke a response that feels disproportionate to the present moment. But for the nervous system, it does not feel disproportionate. It feels necessary. It feels protective.
In that sense, trauma is often a disruption of proper processing. The brain could not make sense of what happened, could not file it where it belonged, and so it keeps returning to it, trying to survive something that has technically ended but has not fully been metabolized.
Big T trauma and little t trauma
People often assume trauma must involve something obviously catastrophic. And sometimes it does. Abuse, assault, traumatic loss, severe neglect, disaster, and violence are all examples of what many would recognize immediately as trauma.
But there are also slower wounds.
Repeated criticism. Emotional absence. Chronic bullying. Living in a home where love is inconsistent and safety is uncertain. The constant drip of instability, dismissal, and fear. These experiences may not always be named with the same gravity, yet over time they can shape the nervous system profoundly.
Some people describe these categories as big T trauma and little t trauma. The distinction can be helpful, but the main point is not comparison. The main point is recognizing that repeated pain still forms patterns. A thousand paper cuts still wound. The human nervous system responds not only to intensity, but also to repetition.
This is one reason many people minimize their own suffering. They tell themselves nothing “that bad” happened, so they should be fine. Yet their body tells another story. Their relationships tell another story. Their anxiety, exhaustion, reactivity, shutdown, or pain tells another story.
When the nervous system gets stuck
At the center of trauma is the nervous system.
When something threatening happens, the body is designed to respond. Fight. Flight. Freeze. Sometimes fawn, which can look like appeasing, people pleasing, or trying to stay safe by becoming what others want. These are not random personality quirks. They are often survival strategies.
In an acute danger, these responses are gifts. If a person is being chased by a bear, they do not need a long reflective conversation with themselves. They need rapid mobilization. The body knows how to do that. The problem is what happens when the danger passes, but the system does not fully reset.
That is when chronic hypervigilance, panic, shutdown, muscle guarding, digestive dysfunction, poor sleep, and persistent pain can begin to take root. The body is no longer simply reacting to danger. It is living as though danger is normal.
This has enormous implications for healthcare. If a person’s system is perpetually stuck in fight or flight, they are not in a good physiological position for healing. Rest and digest functions are compromised. Recovery is compromised. The body may still want to heal, but it lacks the conditions that make healing easier.
The connection between trauma and chronic pain
This is where the conversation becomes especially important for people living with chronic pain.
Pain is real. Tissue matters. Injury matters. Pathology matters. But pain is also more complex than tissue damage alone. It is influenced by threat perception, prior experiences, stress load, nervous system sensitivity, and emotional state. That does not make pain imaginary. It makes pain human.
A person can walk through trauma and later present with back pain, hip tension, headaches, fatigue, digestive issues, or autoimmune flare ups. Another person may have a clear physical injury that is made harder to resolve because the nervous system is under such sustained stress that it cannot regulate well. In both cases, ignoring the trauma dimension means missing part of the picture.
This is why some people improve only so much with physical care alone. Their pain may decrease from a ten to a four. That matters. That is progress. But the system may still be carrying an unresolved burden that keeps pulling it back toward tension, guarding, sensitivity, and exhaustion.
The body and mind are not enemies. They are not separate departments. They are constantly speaking to each other.
The rise in autoimmune issues, inflammation, and dysregulation
One of the more striking observations many clinicians and therapists are making is how often chronic stress and trauma seem to accompany inflammatory problems, autoimmune conditions, weight dysregulation, and chronic illness patterns. Not in every case, and not in a simplistic one to one formula, but often enough to demand attention.
When the body is repeatedly stuck in survival mode, it affects more than mood. It affects sleep, digestion, hormones, energy availability, appetite, immune signaling, and movement patterns. Some people gain weight rapidly. Others lose it rapidly. Some develop chronic tension and pain. Others begin presenting with autoimmune symptoms. Again, no responsible clinician should reduce every illness to trauma. But it is equally unwise to ignore how sustained stress shapes physical health.
A trauma informed perspective does not replace medical wisdom. It deepens it.
Why movement and self care matter
One compelling part of this discussion is the recognition that movement can be protective.
Some individuals with significant trauma histories are still able to regulate more effectively because they keep their body moving. They walk. They train. They stay active. They create rhythms of physical output that help the nervous system process stress and maintain function. That does not mean exercise alone resolves trauma. It does mean the body often benefits when it is invited back into movement rather than left in chronic collapse.
This matters for both clinicians and patients. Care is not merely about naming what is wrong. It is about helping create conditions where healing becomes more possible. That may include therapy, medication in some cases, breath work, movement, sleep support, social safety, spiritual care, and physical treatment. Often, it includes more than one of these at the same time.
Why clinicians need to become trauma aware
This conversation carries a strong challenge for chiropractors, physical therapists, coaches, trainers, and other providers who work closely with people in pain.
You may not be a therapist. You should not pretend to be one. But you do have the privilege of proximity. People often tell their physical providers things they are not ready to say in a counseling office. They may feel less threatened by talking about their body than talking about their inner world. That does not mean the emotional world is absent. It often means it is waiting just beneath the surface.
A trauma aware clinician does not need to force disclosure. They do need to notice. They need to pay attention to disproportionate fear, recurrent flares, unusual guarding, chronic overwhelm, pain that seems entangled with certain histories, and nervous systems that never seem able to settle. They need enough humility to say, “There may be more going on here, and I want to help connect you to the right support.”
That co-management can be life changing.
In many cases, the physical provider becomes a safe bridge. Not the final destination, but the person who helps normalize the need for deeper care.
Healing often requires safety first
One of the clearest insights from trauma work is that people often cannot process what happened while their system is still at full alarm.
If someone is operating at a ten, they may not be able to reflect, grieve, or make sense of anything. Their first need may be regulation. That could involve breath work, medication in some cases, somatic techniques, relational safety, gentle therapy, or simply time with a trustworthy person. The goal is not immediate emotional excavation. The goal is enough stability that the person can begin to process without being overwhelmed.
This principle translates remarkably well across fields. In physical medicine, highly irritated tissue often needs to be calmed before it can be progressively loaded. In trauma therapy, a highly dysregulated nervous system often needs to be calmed before painful memories can be processed. Different tools, same principle. Regulation creates capacity.
The role of truth in healing
Healing is not only physiological. It is also relational and interpretive.
Part of trauma work involves uncovering the beliefs attached to painful experiences. What did this event teach the person about themselves, about other people, about safety, about God, about love, about the future? Many people live from thoughts they have never questioned. “I am unsafe.” “I am too much.” “I am not worth protecting.” “This will always happen again.” “I will never get better.”
These thoughts are not trivial. They shape the nervous system.
This is where cognitive reframing, wise therapy, and the language of Scripture can become deeply meaningful. Taking thoughts captive is not merely a spiritual slogan. It reflects something true about human healing. Lies intensify bondage. Truth interrupts it. The goal is not denial or fake positivity. The goal is learning to identify what is false and cling to what is true.
Where Jesus meets the suffering person
For the Christian, this conversation cannot end with technique alone.
There are real tools that help. Therapy helps. Skilled care helps. Medication can help in certain situations. Movement helps. Co-management helps. But none of these are ultimate. None of them are the deepest answer to human suffering.
Jesus is.
That does not mean every physical symptom disappears instantly. It does not mean every prayer for healing is answered on our preferred timeline. It does mean that true healing is never less than His presence, His peace, His redemption, and His power to restore what is broken.
There is a kind of healing that goes beyond symptom reduction. It is the healing of being seen, known, carried, and redeemed. It is the healing of having your suffering met by the One who entered suffering Himself. It is the healing of truth replacing lies. It is the healing of peace in the middle of pain. And ultimately, it is the healing of eternity, where Christ will make all things new.
This is important because there is a temptation in both modern wellness culture and some Christian spaces to treat healing as something we can demand or engineer. But the posture of Scripture is more relational than transactional. We ask. We lament. We persist. We bring our pain honestly before God. But we do so in surrender, trusting that He is good, that He is near, and that He is writing a larger redemption story than we can yet see.
There is more than survival
Many people live their lives just trying to get from a ten to a four. Sometimes that alone feels miraculous. If you have lived in constant pain, panic, depression, or dysregulation, a four can feel like freedom. And in one sense, that progress should be honored.
But there is also more.
There is more healing. More peace. More wholeness. More freedom. More restoration than many people dare to hope for. Not necessarily a pain free life on demand, but a life increasingly marked by safety, integration, truth, and communion with God.
The body wants to heal. The mind wants to heal. The soul was made for restoration. And the Christian story is, at its heart, the story of God redeeming what sin, suffering, and evil have fractured.
Final thoughts
Trauma is not merely a psychological topic. It is a human one. It touches the body, the brain, the emotions, the immune system, relationships, and spiritual life. Chronic pain is not always just physical. Mental health is not always just mental. The person in front of you is always more than a set of symptoms.
That is why the best care is humble, collaborative, and whole person oriented. It respects the complexity of suffering. It avoids reductionism. And it points, ultimately, beyond itself.
If you are a clinician, let this deepen your compassion. If you are someone carrying pain, let this give language to your experience. And if you are weary, anxious, traumatized, or tired of merely surviving, let this remind you that there is One who does not turn away from the broken.
Go to Jesus.
He is not intimidated by your pain. He is not confused by your nervous system. He is not impatient with your process. And He is not limited to temporary relief. He is the One who heals, restores, and leads His people beside still waters, even in a world that has wounded them deeply.
