Managing Chronic Pain in Survivors of Torture
Abstract
All generalist and specialist clinicians are likely to encounter torture survivors among refugees and asylum seekers. A minority of people survive torture and a smaller minority reach a developed country; those who do tend to be the more resilient and resourceful. They have many health, social and welfare problems; persistent pain in the musculoskeletal system is one of the most common. There is little specific evidence on pain in survivors of torture; the guidelines on interdisciplinary specialist management are applicable. Most of the literature on refugee survivors of torture has an exclusive focus on psychological disorders, with particularly poor understanding of pain problems. This article summarizes the current status of assessment and treatment of pain problems in the torture survivor.
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Chronic pain may probably develop after a physical trauma and become chronic according to the mechanisms underlined above, as in refugees or torture survivors in whom chronic pain is often undiagnosed compared to the psychological sequelae.
“It may probably develop after a physical trauma, and become chronic according to the mechanisms underlined above, as, for example, in refugees or torture survivors in whom CP is often undiagnosed compared to the psychological sequelae.74–76”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [75]
Cites
Central sensitization: implications for the diagnosis and treatment of pain
Woolf, C. J. (2011) · Pain · doi:10.1016/j.pain.2010.09.030 · Cited by 4,771 · see citing works
Porter, M., & Haslam, N. (2005) · JAMA · doi:10.1001/jama.294.5.602 · Cited by 1,793 · see citing works
Pain and emotion: a biopsychosocial review of recent research
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20816 · Cited by 836 · see citing works
The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category
Summerfield, D. A. (2001) · BMJ · doi:10.1136/bmj.322.7278.95 · Cited by 689 · see citing works
Psychological sequelae of torture and organised violence suffered by refugees from Iraq
Gorst‐Unsworth, C., & GOLDENBERG, E. (1998) · The British Journal of Psychiatry · doi:10.1192/bjp.172.1.90 · Cited by 475 · see citing works
Impact of immigration detention and temporary protection on the mental health of refugees
Steel, Z., Silove, D., Brooks, R., Momartin, S., Alzuhairi, B., & Susljik, I. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.bp.104.007864 · Cited by 473 · see citing works
A critical review of psychological treatments of posttraumatic stress disorder in refugees
Nickerson, A., Bryant, R. A., Silove, D., & Steel, Z. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.10.004 · Cited by 457 · see citing works
The emerging evidence for Narrative Exposure Therapy: A review
Robjant, K., & Fazel, M. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.07.004 · Cited by 397 · see citing works
Cisplatin nephrotoxicity: experimental and clinical studies.
Daugaard, G. (1990) · PubMed · Cited by 222 · see citing works
Torture vs Other Cruel, Inhuman, and Degrading Treatment
Başoğlu, M., Livanou, M., & Crnobarić, C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.3.277 · Cited by 200 · see citing works
Neuner, F., Kurreck, S., Ruf, M., Odenwald, M. G., Elbert, T. R., & Schauer, M. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070903121042 · Cited by 191 · see citing works
The health of survivors of torture and organised violence
Burnett, A., & Peel, M. (2001) · BMJ · doi:10.1136/bmj.322.7286.606 · Cited by 142 · see citing works
Predictors of mental health and quality of life in male tortured refugees
Carlsson, J. M., Mortensen, E. L., & Kastrup, M. C. (2006) · Nordic Journal of Psychiatry · doi:10.1080/08039480500504982 · Cited by 129 · see citing works
McFarlane, C. A., & Kaplan, I. (2012) · Transcultural Psychiatry · doi:10.1177/1363461512447608 · Cited by 113 · see citing works
Patel, N., Kellezi, B., & Williams, A. C. D. C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009317.pub2 · Cited by 110 · see citing works
Self-citationPersistent Pain in Survivors of Torture: A Cohort Study
Williams, A. C. D. C., Peña, C. R., & Rice, A. S. C. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2010.02.018 · Cited by 88 · see citing works
Self-citationPsychological assessment, diagnosis, and treatment of torture survivors: A review
Campbell, T. A. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.02.003 · Cited by 86 · see citing works
Torture and its neurological sequelae
Moreno, A., & Grodin, M. A. (2002) · Spinal Cord · doi:10.1038/sj.sc.3101284 · Cited by 83 · see citing works
Chronic pain in torture survivors
Thomsen, A. B., Eriksen, J., & Smidt‐Nielsen, K. (2000) · Forensic Science International · doi:10.1016/s0379-0738(99)00209-1 · Cited by 82 · see citing works
Başoğlu, M. (2009) · American Journal of Orthopsychiatry · doi:10.1037/a0015681 · Cited by 79 · see citing works
Olsen, D. R., Montgomery, E., Bøjholm, S., & Foldspang, A. (2006) · Disability and Rehabilitation · doi:10.1080/09638280600747645 · Cited by 75 · see citing works
Crosby, S. S., Nørredam, M. L., Paasche‐Orlow, M. K., Piwowarczyk, L. A., Heeren, T., & Grodin, M. A. (2006) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2006.00488.x · Cited by 70 · see citing works
Prevalent musculoskeletal pain as a correlate of previous exposure to torture
Olsen, D. R., Montgomery, E., Bøjholm, S., & Foldspang, A. (2006) · Scandinavian Journal of Public Health · doi:10.1080/14034940600554677 · Cited by 57 · see citing works
Rehabilitating torture survivors
Sjölund, B., Kastrup, M. C., Montgomery, E., & Persson, A. (2009) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0426 · Cited by 54 · see citing works
Evaluating the services of torture rehabilitation programmes: history and recommendations.
Jaranson, J. M., & Quiroga, J. (2011) · PubMed · Cited by 49 · see citing works
Williams, A. C. D. C., & Amris, K. (2007) · Pain · doi:10.1016/j.pain.2007.10.001 · Cited by 39 · see citing works
Self-citationTaylor, B. H., Carswell, K., & Williams, A. C. D. C. (2013) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2012.10.281 · Cited by 39 · see citing works
Self-citationClinical Findings in Men With Chronic Pain After Falanga Torture
Prip, K., & Persson, A. L. (2008) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31815aac36 · Cited by 39 · see citing works
MRI of the plantar structures of the foot after falanga torture
Savnik, A., Amris, K., Røgind, H., Prip, K., Danneskiold‐Samsøe, B., Bojsen-Møller, F., Bartels, E. M., Bliddal, H., Boesen, J., & Egund, N. (2000) · European Radiology · doi:10.1007/s003300000476 · Cited by 34 · see citing works
Self-citationMorville, A.-L., Amris, K., Eklund, M., Danneskiold‐Samsøe, B., & Erlandsson, L. (2014) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-014-0004-0 · Cited by 31 · see citing works
Self-citation(2012) · SpringerReference · doi:10.1007/springerreference_308125 · Cited by 30 · see citing works
Prip, K., Persson, A. L., & Sjölund, B. H. (2010) · Disability and Rehabilitation · doi:10.3109/09638288.2010.493597 · Cited by 28 · see citing works
Medical best practices for the treatment of torture survivors.
Mollica, R. F. (2011) · PubMed · Cited by 27 · see citing works
Prevalent pain and pain level among torture survivors: a follow-up study.
Olsen, D. R., Montgomery, E., Carlsson, J. M., & Foldspang, A. (2006) · PubMed · Cited by 24 · see citing works
(1990) · The Lancet · doi:10.1016/0140-6736(90)92034-f · Cited by 21 · see citing works
Long-term consequences of falanga torture--what do we know and what do we need to know?
Amris, K., Torp‐Pedersen, S., & Rasmussen, O. V. (2009) · PubMed · Cited by 19 · see citing works
Self-citationEvaluating interventions for posttraumatic stress disorder in low and middle income countries
Mundt, A. P., Wünsche, P., Heinz, A., & Pross, C. (2013) · Intervention · doi:10.1097/wtf.0000000000000001 · Cited by 18 · see citing works
Can we prevent doctors being complicit in torture? Breaking the serpent's egg.
O’Connor, M. (2009) · PubMed · Cited by 17 · see citing works
Patel, N., Këllezi, B., & Williams, A. C. D. C. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009317 · Cited by 17 · see citing works
Self-citationPrip, K., Persson, A. L., & Sjölund, B. H. (2012) · BMC International Health and Human Rights · doi:10.1186/1472-698x-12-39 · Cited by 15 · see citing works
Treatment of torture victims--a longitudinal clinical study.
Danneskiold‐Samsøe, B., Bartels, E. M., & Genefke, I. K. (2007) · PubMed · Cited by 15 · see citing works
The epidemiology of falanga--incidence among Swedish asylum seekers.
Edston, E. (2009) · PubMed · Cited by 15 · see citing works
Doctors' involvement in torture.
Jesper, S. (2008) · PubMed · Cited by 14 · see citing works
Pregabalin for the Management of Neuropathic Pain in Spinal Cord Injury
Dalal, K. L., Felix, E. R., & Cardenas, D. D. (2013) · Pain Management · doi:10.2217/pmt.13.35 · Cited by 14 · see citing works
Prip, K., Persson, A. L., & Sjölund, B. H. (2012) · BMC International Health and Human Rights · doi:10.1186/1472-698x-12-40 · Cited by 11 · see citing works
Chronic pain in survivors of torture.
Amris, K., & Williams, A. (2007) · UCL Discovery (University College London) · Cited by 9 · see citing works
Self-citationWestermeyer, J. J., Hollifield, M. A., Spring, M., Johnson, D., & Jaranson, J. M. (2011) · PubMed · Cited by 7 · see citing works
Torp‐Pedersen, S., Amris, K., Holm, C. C., Kønig, M. J., Prip, K., & Danneskiold‐Samsøe, B. (2009) · PubMed · Cited by 6 · see citing works
Self-citationUnderstanding pain from torture: cultural considerations
Williams, A. C. D. C., & Volkmann, A.-M. (2010) · UCL Discovery (University College London) · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
3 of the 53 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Pain in persons who are marginalized by social conditions
Craig, K. D., Holmes, C., Hudspith, M., Moor, G., Moosa-Mitha, M., Varcoe, C., & Wallace, B. B. (2019) · Pain · doi:10.1097/j.pain.0000000000001719 · Cited by 205 · see citing works
Pain as a threat to the social self: a motivational account
Karos, K., Williams, A. C. D. C., Meulders, A., & Vlaeyen, J. W. S. (2018) · Pain · doi:10.1097/j.pain.0000000000001257 · Cited by 133 · see citing works
Self-citationSchippert, A. C., Grov, E. K., & Bjørnnes, A. K. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246074 · Cited by 44 · see citing works
Pollanen, M. S. (2017) · Forensic Science International · doi:10.1016/j.forsciint.2017.12.022 · Cited by 35 · see citing works
The implications of war captivity and long-term psychopathology trajectories for telomere length
Solomon, Z., Tsur, N., Levin, Y., Uziel, O., Lahav, M., & Ohry, A. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.04.004 · Cited by 32 · see citing works
Interventions for treating persistent pain in survivors of torture
Baird, E., Williams, A. C. D. C., Hearn, L., & Amris, K. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012051.pub2 · Cited by 31 · see citing works
Self-citationTsur, N., Defrin, R., & Ginzburg, K. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000461 · Cited by 29 · see citing works
Pain from torture: assessment and management
Amris, K., Jones, L. E., & Williams, A. C. D. C. (2019) · PAIN Reports · doi:10.1097/pr9.0000000000000794 · Cited by 26 · see citing works
Self-citationKaur, G., Weinberg, R. Y., Milewski, A., Huynh, S., Mauer, E., Hemmings, H. C., & Pryor, K. O. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003108 · Cited by 26 · see citing works
Torturing personification of chronic pain among torture survivors
Tsur, N., Shahar, G., Defrin, R., Lahav, Y., & Ginzburg, K. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.06.016 · Cited by 23 · see citing works
Special Considerations for the Treatment of Pain from Torture and War
Williams, A. C. D. C., & Baird, E. (2016) · Current anesthesiology reports · doi:10.1007/s40140-016-0187-0 · Cited by 20 · see citing works
Self-citationTsur, N., Defrin, R., Shahar, G., & Solomon, Z. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.031 · Cited by 13 · see citing works
Rizkalla, N., Alsamman, S., Bakr, O., Masud, H. R., Sbini, S., & Segal, S. P. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2400833 · Cited by 12 · see citing works
Suspension torture and its physical sequelae
Woldu, S., & Brasholt, M. (2021) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2021.102155 · Cited by 10 · see citing works
Interventions for treating persistent pain in survivors of torture
Baird, E., Williams, A. C. D. C., Hearn, L., & Amris, K. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012051 · Cited by 9 · see citing works
Self-citationTsur, N., Defrin, R., Levin, Y., Itzhaky, L., & Solomon, Z. (2019) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000437 · Cited by 8 · see citing works
Core competencies for physiotherapists working with refugees: a scoping review
McGowan, E., Beamish, N., Stokes, E., & Lowe, R. (2020) · Physiotherapy · doi:10.1016/j.physio.2020.04.004 · Cited by 8 · see citing works
Gamble, A., Ahmed, A. M. A., Rahim, S. H., & Hartman, J. (2020) · Torture Journal · doi:10.7146/torture.v30i2.119199 · Cited by 8 · see citing works
Torture survivors’ experiences of receiving surgical treatment indicating re- traumatization
Schippert, A. C., Dahl‐Michelsen, T., Grov, E. K., Sparboe-Nilsen, B., Silvola, J. T., & Bjørnnes, A. K. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287994 · Cited by 8 · see citing works
One ‘knows’: self-rated health and telomere length among ex-prisoners of war
Tsur, N., Levin, Y., Abumock, H., & Solomon, Z. (2018) · Psychology and Health · doi:10.1080/08870446.2018.1509977 · Cited by 8 · see citing works
<p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p>
D'Ippolito, M., Purgato, A., & Buzzi, M. G. (2020) · Journal of Pain Research · doi:10.2147/jpr.s236507 · Cited by 7 · see citing works
Mirza, M. P., Trimboli, C., Hartman, J., Gamble, A., Rfat, M., Bentley, J. A., Gross, M., AlHeresh, R. A., Hussein, Q., & Markos, T. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.05.002 · Cited by 7 · see citing works
Zerach, G., Shevlin, M. E., & Solomon, Z. (2020) · Health Psychology · doi:10.1037/hea0001030 · Cited by 7 · see citing works
Torture and Sequels to Persecution: A Global Challenge
Wenzel, T., Ekblad, S., Kastrup, M. C., & Musisi, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-70554-5_25 · Cited by 5 · see citing works
Chang, W., Andersen, C., Berisha, B., Estrup, O., & Wang, S. (2018) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-2322 · Cited by 5 · see citing works
Oren, T., Ercanli, N., Maayan, O., Tham, S., Wright, D., & Kaur, G. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0003070 · Cited by 4 · see citing works
Guidelines for handling released captives before transfer to medical facilities in Israel
Shelef, L., Rubinstein, R., Shoval‐Zuckerman, Y., Rotschield, J., & Bechor, U. (2025) · Military Psychology · doi:10.1080/08995605.2025.2564506 · Cited by 2 · see citing works
Barriers to optimal chronic pain management in refugees: a scoping review
Bilney, E. V. M., Vasenius, M., Mitchell, J., Downing, J. D., François, P.-M., McCall, S. J., & Forget, P. (2026) · BMC Public Health · doi:10.1186/s12889-026-26206-w · Cited by 2 · see citing works
Physical therapy for survivors of torture: A scoping review
Dee, J. M., Gell, N., van Eeghen, C., & Littenberg, B. (2024) · Torture Journal · doi:10.7146/torture.v34i1.138985 · Cited by 2 · see citing works
Kavchak, A. J. E., Hegedus, T., Mani, R., & Baxter, D. G. (2019) · Physical Therapy Reviews · doi:10.1080/10833196.2019.1701762 · Cited by 1 · see citing works
Garofano, M., Ascoli, M. M., & Palumbo, R. (2020) · Journal of Advanced Health Care · doi:10.36017/jahc2001-003
Evil and Pain: A Multi-modal View to Approach Pain-Related Conditions
Buzzi, M. G., Purgato, A., & D’Ippolito, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-91888-0_2
Garofano, M., Ascoli, M. M., & Palumbo, R. (2020) · Journal of Advanced Health Care · doi:10.36017/jahc20202149
Joo, B., Marquez, J. L., Young, A. M., & Osmotherly, P. G. (2024) · Research Square · doi:10.21203/rs.3.rs-5285159/v1
Pain Issues in Individuals with Limited Ability to Communicate Due to Neurocognitive Impairments
Nebzydoski, C. H., & Radlicz, C. M. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-10583-8.00041-6
- Authors
- Amris, K., & Williams, A. C. D. C.
- Affiliations
- Bispebjerg Hospital (DK)
- University College London (GB)
- Venue
- Pain Management
- Publisher
- Informa UK Limited
- Published
- 2014-12-24
- Volume
- 5
- Issue
- 1
- Pages
- 5-12
- ISSN
- 1758-1869 (ISSN-L)
- 1758-1877
- OpenAlex
- W1986937526
- Cited by
- 36
- References
- 53
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 2
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain Management (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Parker Institute
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Sociology and Political Science › Torture, Ethics, and Law
- Keywords
- chronic pain, torture survivors, refugees, asylum seekers, musculoskeletal pain, pain assessment, multidisciplinary care, resilience, mental illness
- MeSH terms
- Humans, Refugees, Stress Disorders, Post-Traumatic, Torture, Survivors, Chronic Pain, Pain Management
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