Childhood maltreatment is a worldwide problem, leading to many medical and psychiatric conditions in adulthood, especially pain disorders. Headache has been found to be associated with emotional, sexual, and physical abuse in an important research study. In another study, the association with migraine was stronger for emotional abuse than for sexual or physical abuse. These results remain significant after adjusting for depression and anxiety.
Similar findings have been seen in other pain conditions, including fibromyalgia, irritable bowel syndrome, interstitial cystitis, and TMJ disorders. These conditions are often called complex persistent pain, are associated with central sensitization of pain receptors, and probably have a shared pathogenesis. Abuse-induced stress during childhood, a time that the brain has plasticity, could lead to psychobiological changes that enhance pain sensitivity. See Neurology 84, January 13, 2015, page 132-140.