Trigger warning: This article contains material regarding sexual abuse and sexual trauma that some readers may find upsetting or disturbing.

Every 98 seconds someone in the U.S. is sexually assaulted, usually by someone they know well. The statistics on sexual assault are only part of the picture. What numbers and charts cannot tell you is that the legacy of sexual abuse can often lead to chronic pain. Chronic pain and sexual abuse are connected in ways that researchers are only now beginning to understand.

Sexual abuse isn’t an isolated incident

Sexual abuse is sexual activity that is unwanted, unwelcome, and unsolicited. The perpetrators of sexual abuse use threats, physical force, or the threat of physical force to take advantage of victims who either do not give consent or who are not able to give consent.

There are different types of sexual abuse and trauma.

  • Sexual assault (adult or child): This includes rape, either by a single perpetrator or multiple. Rape includes any type of penetration, including oral sex.
  • Partner sexual violence: 80% of sexual violence is perpetrated by someone the victim knows. Six of ten assaults occur in the house of a friend, relative, or neighbor. This is by far the most common type of sexual abuse.
  • Incest: This is non-consensual sexual activity between related siblings.
  • Sexual molestation: Sexual molestation is non-consensual touching of the sexual organs and the breasts.
  • Sexual abuse of the elderly or disabled: This type of abuse is most often committed by caregivers.

Other less common but no less serious types of sexual abuse include:

  • Sexual abuse of inmates
  • Military sexual assault
  • Sexual assault by or to people in the helping professions (e.g., doctors, nurses)

The process of abuse 

It does not matter the type of abuse, how long it has occurred, or who the perpetrator is. Sexual abuse in any form for any period of time is a traumatic act. It has physical, emotional, and psychological effects. Although primarily seen as a physical act, sexual abuse does not occur in a vacuum.

Some victims of sexual abuse may have been “groomed” by their assailant for years, a process that creates deep psychological scars. In other cases, sexual abusers create an atmosphere of shame, silence, and isolation. Victims may feel helpless, hopeless, and deserving of the abuse they are facing.

Regardless of the circumstances, sexual abuse is linked to not only immediate physical and psychological responses but also long-term problems that include chronic pain.

What we know about chronic pain and sexual abuse

Researchers define trauma as a psychological reaction to an overwhelmingly terrible event. More and more, researchers understand that trauma can also cause a physical reaction. Researchers have noted an unmistakable link between chronic pain and the trauma of sexual abuse.

Sexual abuse can trigger chronic pain

Sexual trauma that is violent in nature (as opposed to coercive) can trigger chronic pain in a previously pain-free person. This may be a result of actual physical harm as a result of the act, or it may be a post-traumatic stress response. Although the vast majority of victims have some form of PTSD directly following their attack, as many as 50% of rape survivors experience PTSD symptoms for decades after their assault.

Part of this may be a physical response, but so