PTSD and pain - when the body stores memories

How physiotherapy and occupational therapy can help people with post-traumatic stress disorder

Traumatic experiences leave their mark - not only on the psyche, but also on the body. Many people with post-traumatic stress disorder (PTSD) suffer from chronic pain: their head, back, stomach or joints ache, even though there is often no clear medical cause. The explanation often lies not in the tissue - but in the connection between the nervous system, body memory and incompletely processed memories.

Pain as the language of the body

In many cases of PTSD, the nervous system is permanently overactivated. The body remains in a state of alert: muscle tone increases, sleep is disturbed and the processing of stimuli changes. Pain is perceived more quickly, experienced more intensely and is less well regulated. In many cases, a central sensitization develops - the pain system fires permanently, even without a physical trigger.

At the same time, the body is a place of trauma for many of those affected: touch can have a threatening effect, internal conditions such as tightness, trembling or pressure are experienced as a re-experiencing of the trauma. This causes pain not only physiologically, but also emotionally and symbolically.

Symptoms that occur frequently:

• Chronic pain (back, neck, head, pelvis)

• Muscle tension, "frozen" posture

• Sleep disorders, exhaustion, listlessness

• Fear of movement or touch

• Dissociative states under stress

• Somatic stress reactions (palpitations, shortness of breath, dizziness)

Therapy begins with safety

For people with PTSD, the most important thing is a safe space. Only when the nervous system senses that there is no danger can tension be released. In therapy, this means

• Transparency: every touch, every exercise is explained

• Control: The person concerned determines the pace, proximity and intensity

• Stabilization: self-regulation comes before confrontation

Physiotherapy and occupational therapy can achieve a lot - if they are adapted

In body-oriented work with PTSD, fewer stimuli and more mindfulness are needed. The focus is on:

🟡 Perception instead of performance enhancement

Training that makes your own body tangible, controllable and trustworthy often has a deeper effect than strength or endurance programs.

🟡 Respiratory therapy & vegetative regulation

Conscious breathing, vagus activation, gentle movement and grounding help to calm the overstimulated nervous system.

🟡 Making physical boundaries tangible

Proprioception exercises, contact with the environment (e.g. walking barefoot, ball exercises), conscious self-touch or yoga can help you to experience your body "as home" again.

🟡 Integration into everyday life

Pain and stress management techniques in everyday life (e.g. micro-pacing, safe routines, mini-retreat islands) promote self-efficacy.

🟡 Creative, non-verbal methods

In occupational therapy, creative processes, music, rhythm or flow of movement can open up new ways of expression when words fail.

Interdisciplinary thinking: body and mind are inseparable

Accompanying psychotherapeutic treatment is essential for PTSD. Body therapy methods cannot heal, but they can stabilize, alleviate functional symptoms and contribute to processing.

Our task as therapists is not to "work through the trauma", but to calm the body, promote self-regulation and offer a therapeutic relationship based on trust, dignity and competence.

Conclusion: Understanding pain - seeing people

PTSD is more than a psychological diagnosis. It is a condition in which the body, nervous system and life story are closely intertwined. When pain and trauma come together, there is no need for standard solutions, but rather individual, mindful, body-oriented support.

Physiotherapy and occupational therapy can make a valuable contribution here: not only to reduce pain, but also to strengthen body confidence, promote self-efficacy - and sometimes also as the first bridge back into life.

👉 Would you like to deepen your therapeutic knowledge of trauma, chronic pain and the nervous system?

Then discover our training courses on pain physiology, autonomic regulation and body-oriented therapy at:
🌐 www.hockenholz.com/weiterbildungen