More and more research keeps coming back on the effects of what we call Adverse Childhood Events (ACEs) in a person’s life. While no normal person seeks to cause harm to children regardless of the downstream effects, acknowledging the impacts of such ACEs on individuals and society helps guide further research into both prevention and treatment after the fact. Other studies have indicated that ACEs impact on a variety of chronic health conditions such as cancer, cardiovascular, and more. These conditions already have decent reporting systems to gauge such impacts of ACEs. This study looks at a vaguer condition: chronic pain.
The statistics for chronic pain are impressive in all the wrong ways. According to the Center for Disease Control report, almost 21% percent of U.S. Adults experienced some form of chronic pain in 2021. This amounts to over 51 million adults. The same report estimates that over 17 million experienced what they call “high-impact chronic pain” meaning that some significant reduction in daily activities resulted from the pain. Without going into the factors driving this, we can safely conclude that Americans hurt a lot.
To assess the potential impact of ACEs on these painful statistics, this study performed a systematic review of the medical literature to identify quality studies for a meta-analysis. Initially they identified 85 studies covering over 800,000 adults, but narrowed the final number down to 57 studies for the final analysis. The studies included various types of chronic pain including both musculoskeletal and non-musculoskeletal disorders. The non-musculoskeletal disorders included conditions like headaches and migraines. With mixed results of prior similar attempts by other groups. This groups wanted to provide a more reliable picture of ACE contribution to such chronic pain.
After analysis, the authors found several concerning statistics. Exposure to Adverse Childhood Events (ACEs) in childhood increased the rate of chronic pain conditions in adults by somewhere between 40 and 60 percent. The incidence of a pain related disability was estimated to be 29% higher after ACEs. They also found a dose response curve, meaning that as more ACEs were reported, the risk of a chronic pain condition increased.
Clearly ACEs correlated with adult chronic pain conditions but why? The paper only speculated on possible mechanisms; among the possibilities offered were that ACEs could alter neurological connections which increase pain sensitivity throughout life and that they could be associated with flattened cortisol diurnal curves and thus impact on tissue repair and stress responses. Considering that an estimated one-half of the 1 billion children worldwide are at risk of current ACEs, the potential impact of a proper understanding of this issue is immense. Note that this estimate of half of the world’s children includes physical and emotional abuse as well as neglect (all of which qualify as ACEs).
With such a large number of children at risk with such potential impact on society, what are we waiting on? Basically, we need real solutions. The authors offer ideas such as trauma informed care and rehabilitation programs. These do provide positive outcomes in studies, demonstrating that the impact of ACEs is not absolute and unavoidable. However, unless we face the fact that our world is broken by sin and resources are limited, many will still suffer. Simply throwing more money at more healthcare will not make up for a societal wide failure.
Not even functional medicine can solve this problem, not on its own. This problem needs a whole person solution that includes the spiritual component of who we are and addresses the relational reality of life. Children are at the receiving end of ACEs, with practically no ability to choose the life impact they receive. Someone else around them possesses the greatest influence over whether they have an ACE and how it happens. While not all ACEs are avoidable, guiding a child through the processing of the ACE must occur with the spiritual meaning of life in mind. No child should experience ACEs without the relationship of a caring and mature adult to support and protect them.
Such guidance and such relational care must be guided by a Biblical view of life. Worldviews which portray a false view of God or a missing God will not fully address this need. Helping children restore healthier more abundant lives after an ACE requires whole person care through relationship.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.