Physical Activity Moderates the Association Between Pain and PTSD in Treatment-Seeking Veterans

Posttraumatic stress disorder (PTSD) and pain are frequently comorbid conditions that can result in bidirectional exacerbations. Initial research suggests physical activity may prevent PTSD symptoms or assist with recovery. Unfortunately, Veterans with PTSD are less likely to engage in physical activity, often citing pain as a primary reason. The current study examines the potential role of physical activity as a moderator of the pain and PTSD relationship.

Data were collected from 239 Veterans who were seeking PTSD treatment at a Veterans Affairs (VA) hospital between 2006 and 2013. Veterans completed the Clinician-Administered PTSD Scale (CAPS) to measure PTSD severity and self-report inventories to measure pain and physical activity. Multiple moderated linear regressions were used to examine the influence of physical activity on the relationship between pain and PTSD symptoms.

Pain severity and interference were associated with more severe PTSD. Physical activity did not have main effects on PTSD severity. However, it did moderate the relationship between PTSD and pain, such that those who were active, despite high levels of pain severity or pain interference, had fewer PTSD symptoms.

For Veterans seeking treatment for PTSD, physical activity was particularly salient for those reporting high levels of pain severity and intensity. While assessment of pain is recommended with all Veterans, it may also be beneficial to evaluate physical activity in those with prominent pain complaints. Further examination of the role of exercise in integrated care for pain and PTSD is warranted.