Episode 52: The Trauma Behind Chronic Pain with Dr. Les Aria

Listen to Episode 52 with Dr. Les Aria →

When Your Body Won't Stop Hurting

You've had scans and tests that show your injury healed months or years ago. Doctors tell you there's no structural reason for your continued pain. But the pain is absolutely real and affects every aspect of your daily life.

You've tried physical therapy, medications, injections, and maybe even surgery. Nothing provides lasting relief. The pain persists despite all interventions aimed at the tissues where you feel it.

Chronic pain isn't just about tissue damage or injury. It's about your autonomic nervous system stuck in a protective pattern that keeps amplifying pain signals. And trauma plays a major role in why that pattern persists.

Dr. Les Aria joins me today as a pain psychologist with 19 years in practice and co-founder of Menda Health, a digital pain recovery platform. He explains chronic pain through the Polyvagal Lens and helps us understand what's actually happening in your nervous system when pain becomes chronic. We explore why understanding the trauma behind pain changes your entire recovery approach.

Your Nervous System's Role in Chronic Pain

Chronic pain isn't just a signal from damaged tissue telling your brain something is wrong. Your autonomic nervous system amplifies and maintains pain signals long after tissue heals. The pain persists even when structural damage no longer exists because your nervous system stays stuck in the pattern.

Dr. Aria uses Dr. Stephen Porges' Polyvagal Theory framework to explain chronic pain from a nervous system perspective. When your nervous system stays in defense mode through sympathetic activation or dorsal vagal shutdown, pain becomes the default state your body maintains. Your system amplifies pain signals as a protective mechanism even when no actual threat or injury exists.

Understanding the Biology of Trauma® reveals the trauma-pain connection that conventional pain treatment misses. Trauma dysregulates your nervous system fundamentally and that dysregulation shows up as chronic pain in your body. Your body perceives threat constantly and uses pain as a protective signal even when no injury exists to protect against.

The autonomic nervous system's stuck patterns explain why pain persists long after healing completes. Tissue heals relatively quickly through normal biological processes. But your nervous system can stay stuck in the pain pattern indefinitely through neuroplasticity that reinforces protective responses. That's neuroplasticity working against you by cementing pain patterns that no longer serve a protective function.

When Protection Becomes the Problem

Pain functions as your body's protection signal that alerts you to danger or injury requiring attention. When trauma makes your nervous system hypervigilant about threat, it amplifies pain signals to keep you safe from perceived danger. The protection mechanism that once served you becomes the problem when it won't turn off.

Dr. Aria explains that chronic pain lives at the intersection of biology and psychology in ways that require addressing both. As a pain psychologist, he understands the biological mechanisms creating pain and the psychological patterns that maintain it. Effective treatment must address both the nervous system dysregulation and the mental-emotional aspects of living with chronic pain.

The trauma behind chronic pain often goes unaddressed in conventional pain treatment approaches. Doctors focus on finding and fixing structural problems through imaging, procedures, and surgeries. They miss that your nervous system is stuck in a protective pattern from unresolved trauma that keeps amplifying pain signals regardless of tissue condition.

When your autonomic nervous system stays dysregulated from trauma, your pain threshold lowers and your pain amplification increases. Small sensations that wouldn't register as pain in a regulated nervous system get amplified into significant pain. Your system interprets neutral or mildly uncomfortable sensations as dangerous threats requiring intense pain signals to protect you.

Breaking the Chronic Pain Cycle

Recovery from chronic pain requires nervous system regulation rather than just pain management through medications or procedures. You have to address the trauma and autonomic dysfunction underneath the pain symptoms. Treating pain without addressing the dysregulated nervous system maintaining it provides only temporary relief at best.

Dr. Aria co-founded Menda Health as a digital platform for pain recovery that addresses the nervous system piece most pain treatment misses entirely. The platform helps people understand their pain through a nervous system lens and provides tools for regulation that allow the pain pattern to finally shift.

Breaking the chronic pain cycle involves working with your Biology of Trauma® to shift your nervous system out of chronic defense mode. This requires building safety in your system, regulating your autonomic nervous system through specific practices, addressing the trauma that created the dysregulation originally, and retraining your nervous system through neuroplasticity to respond differently to sensations.

The Polyvagal perspective on chronic pain reveals why so many conventional treatments fail to provide lasting relief. They target the pain sensation itself without addressing why your nervous system keeps producing and amplifying that pain signal. When you understand that chronic pain is your nervous system stuck in a protective pattern from trauma, you can finally address the root cause rather than just managing symptoms.

Dr. Aria's work demonstrates that chronic pain recovery is possible when you address the autonomic nervous system and trauma underneath. People who've had pain for years or decades can experience significant improvement when they work with their nervous system regulation rather than continuing to chase structural fixes for pain that's neurological in origin.

This Episode Is For:

✓ People with chronic pain that won't resolve despite medical treatment 

✓ Anyone told their pain is "in their head" when it feels completely real 

✓ Practitioners working with chronic pain clients who need the nervous system perspective 

✓ Those whose pain persists after tissue healing is complete 

✓ Anyone recognizing the connection between their trauma and their pain 

✓ People ready to understand pain through the autonomic nervous system lens

What You'll Learn

Listen to understand the autonomic nervous system's role in chronic pain and why addressing the trauma underneath is essential for recovery. Discover how Polyvagal Theory explains why pain persists after healing. Learn why nervous system regulation matters more than structural fixes for chronic pain rooted in dysregulation.

Your chronic pain might be your nervous system stuck in a protective pattern from unresolved trauma.

Listen to Episode 52 with Dr. Les Aria →

Disclaimer

This podcast is for educational purposes only and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. The information shared reflects my clinical expertise and research, but every person's biology and healing journey is unique. Always consult with qualified healthcare providers before making changes to your treatment plan or starting new interventions. If you're experiencing a mental health crisis, please contact emergency services or a crisis helpline immediately.

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