I feel like I'm a little late to the party on this one, because I'm not clear yet why chronic and/or excruciating chronic pain would be a hallmark of PTSD, but according to the veterans I know, it's one of the most difficult conditions they face. So, obviously, one worth discussing and learning more about.
The VA's site has some information about chronic pain and PTSD linked here, but it seems like fairly generic information, and not much of it is related to combat trauma specifically. So I guess we need to "tie a string" around this topic and come back to it, when we learn more. My guess is there's something about "adrenaline gone wild" in combat that sears these graphic memories into the body as a form of pain, and then the pain gets "refreshed" whenever the adrenaline gets refreshed. Obviously, this is pretty rudimentary (and possibly even, completely wrong...) but, stranger things have happened; and I've personally heard odder things from medical specialists who later just threw in the towel on things that weren't as obvious as they seemed at first.
Certainly there are landmark books in the Mind-Body Medicine spectrum of approaches, such as the "The MindBody Prescription: Healing the Body, Healing the Pain," by John Sarno, M.D., (recommended by Andrew Weil, M.D.); and "Wherever You Go, There You Are: Mindfulness Meditations in Everyday Life," and other books written by Jon Kabat-Zinn, Ph.D., that address mindfulness meditation as a coping strategy for chronic pain (whether physiological or psychological in origin.) (Patience Mason's husband, Vietnam veteran Robert Mason, the author of Chickenhawk, apparently thinks Zinn's work is great.) And there are other forms of "energetic medicine" (e.g., acupuncture, in particular) are good at lessening the experience of pain so that it can be managed, sometimes also reducing the source.
And on the topic of is pain really the enemy, or is it more likely actually part of us -- there's almost nothing better than the Claude Anshin Thomas quote, excerpted from his book, At Hell's Gate: A Soldier's Journey from War to Peace, that we blogged about back in March of 2006. If you're not familiar with what he said, go here and read that entry. His perspective is sensational, and as often-wounded Vietnam veteran, his experience counts on this matter.
So it will be interesting, over time, to see where this goes, and take a look at "different strategies that might work" for pain control and pain management. All I know for sure, from the veterans I've talked to, is that it's a MUST to cover, because it's a crucial, nonstop, searing reality of their lives. And that's nothing to take lightly.
