The relationship between childhood traumas and chronic pain in adulthood: a scoping review and a conceptual model of the biological and psychological mechanisms underlying this relationship

While the relationship between post-traumatic stress disorder (PTSD) and chronic pain is increasingly highlighted, the link between childhood traumas (CT) and chronic pain in adulthood remains underexplored. Yet, it is well established that early adverse experiences (ACES) are more damaging than those experienced later in life due to ongoing neurological and psychological development. Furthermore, survivors of childhood traumas may develop more complex and multifaceted reactions than those observed in PTSD, potentially leading to Complex PTSD (CPTSD). A scoping review was conducted to explore the association between childhood traumas and chronic pain in adulthood, with a focus on identifying the psychological and biological mechanisms involved. Following PRISMA-ScR guidelines, 20 peer-reviewed articles were selected and thematically analyzed. Inclusion criteria covered empirical studies involving adult populations, published between 2005 and 2025. A strong association was found between cumulative ACEs and chronic pain, which supports the additional impacts of CPTSD compared to PTSD in chronic pain. Only three studies included focused on the specific impact of each CT and showed that emotional neglect and emotional abuse had the most persistent impact. Key mechanisms mainly included central sensitization, emotional dysregulation and affective disorders. Further studies are needed to investigate the differential impact of each childhood trauma type, including emotional neglect and abuse, and various pain conditions. These findings support the hypothesis of a specific emotional pathway from early adversity to pain chronification.