Adverse childhood experiences and the psychopathogenesis of chronic pain: A narrative review

Aim: To explore the influence of Adverse Childhood Experiences (ACEs), including abuse, neglect, and household dysfunction, on the development and persistence of chronic pain in adulthood. The review emphasizes psychopathogenetic and biopsychosocial mechanisms that mediate the relationship between early trauma and chronic pain syndromes.

Materials and Methods: This narrative review synthesizes data from 42 peer-reviewed clinical and experimental studies published between 1998 and 2025. Literature was retrieved from PubMed, Scopus, Web of Science, Google Scholar, ScienceDirect, and SpringerLink using keywords such as "childhood trauma," "chronic pain," "neurobiology of pain," and "central sensitization." Inclusion criteria focused on full-text articles addressing neuroendocrine, emotional, and behavioral consequences of ACEs. Special attention was given to mechanisms involving chronic stress, emotional dysregulation, altered pain perception, and maladaptive coping strategies.

Conclusions: ACEs are significant contributors to the psychopathogenesis of chronic pain. They disrupt neurobiological regulation, intensify emotional vulnerability, and alter pain processing pathways. The biopsychosocial model provides a comprehensive framework for understanding these interactions. Trauma-informed care and targeted education - centered on emotional awareness and conscious pain regulation - are essential for improving treatment outcomes and promoting holistic recovery. Recognizing the long-term impact of ACEs is vital for developing effective rehabilitation strategies and empowering affected individuals.