"My body will never be the same as it was before. There’s no time that you can’t feel the 7 or 8 inches of scar tissue running through the middle of your stomach. It’s just a constant physical reminder, because you can’t leave your body."
This powerful testimony from Mia Tretta, a survivor of two separate gun violence incidents, underscores a profound and often overlooked consequence of such attacks: chronic pain. Beyond the immediate trauma and loss of life, gun violence inflicts deep and lasting physical and psychological wounds, as evidenced by emerging research and the lived experiences of survivors. A recent study highlights the inextricable link between exposure to gun violence, whether direct or indirect, and the increased prevalence of chronic pain, revealing a public health crisis with far-reaching implications.
Mia Tretta’s journey through the harrowing landscape of gun violence began in 2019, a freshman at Saugus High School in Santa Clarita, California. During a brutal attack by a fellow student, a .45-caliber semiautomatic handgun unleashed a torrent of violence that claimed the lives of two of her classmates, including her best friend, and left two others injured. Tretta herself was struck in the stomach by a bullet, a wound that would mark her physically and psychologically for years to come. Miraculously, she survived, but the physical and emotional scars would prove to be indelible.
Years later, as a college junior at Brown University, Tretta found herself once again in the terrifying grip of an active shooter situation in December 2025. While studying for finals in her dorm room, the familiar dread washed over her. As alerts flooded her phone detailing the unfolding crisis on campus, an unexpected and deeply unsettling sensation coursed through her: a phantom pain in her stomach, precisely where she had been shot years earlier. This phenomenon, which she aptly named "phantom bullet syndrome," mirrors the well-documented phantom limb syndrome, where individuals experience sensations in a limb that has been amputated. For Tretta, this manifestation occurred during moments of extreme stress, a visceral echo of past trauma.
Reflecting on her experiences, Tretta articulated a profound and somber perspective on her survival. "It’s crazy to say that the first time, I was the lucky one because though I got shot, I didn’t get killed," she shared. "And the second time, I was the lucky one because I was a few blocks away." Her words encapsulate the grim reality for a growing number of young people who have endured multiple encounters with gun violence, a generation increasingly desensitized to the pervasive threat.
Tretta’s personal narrative is not an isolated incident but rather a potent illustration of the findings from a groundbreaking study published in BMC Public Health in January. This research provides robust evidence linking exposure to gun violence, in its myriad forms, to elevated rates of chronic pain among American adults. The study, conducted by researchers at Rutgers University, meticulously examined six distinct types of gun violence exposure: being shot, being threatened with a gun, hearing gunshots, witnessing a shooting, knowing a friend or family member who was shot, and knowing someone who died by firearm suicide. Analyzing data from a nationally representative survey of 8,009 individuals, the researchers discovered that a significant portion of the population experiences persistent pain, with 23.9% reporting pain on most days or every day, and 18.8% indicating they experienced a lot of pain.
Daniel Semenza, the lead author of the study and director of research at the New Jersey Gun Violence Research Center, emphasized the deep and intertwined nature of mental and physical health in the context of gun violence. "Whether someone has lost a person to gun violence or they’ve been shot themselves, their mental and physical health are inextricably linked," Semenza explained. He elaborated on the physiological impact of trauma, stating, "Your body, through the experience of post-traumatic stress, is going to feel as if it’s happening over and over and over again." This cyclical nature of trauma can manifest in persistent physical symptoms, even in the absence of ongoing physical injury.
Tretta’s physical ordeal extended beyond the initial gunshot wound. She underwent multiple surgeries in an attempt to remove the bullet, but fragments remain lodged within her body years later. A nerve block was administered to manage ongoing pain, a testament to the persistent physical ramifications of her injury. Furthermore, she was diagnosed with psoriatic arthritis, a chronic autoimmune disease characterized by joint inflammation, pain, swelling, and stiffness. "I have dealt with chronic pain, immunodeficiencies, and bodily differences ever since the shooting happened," Tretta revealed. She described how even a simple fever now presents a significantly different and more severe experience compared to before the shooting, with uncontrollable shaking and excruciating pain upon touch.
The Rutgers study stands as one of the earliest comprehensive investigations to specifically focus on chronic pain as a direct outcome of gun violence exposure, contributing to a growing body of research on the broader physical health toll of such incidents. "It highlights the fact that, for the thousands of people who are killed every year, there are lots of people who knew those folks," Semenza noted. "The toll of gun violence is much broader than we originally anticipated." This sentiment is echoed by Efrat Eichenbaum, an inpatient psychologist who has treated gun violence survivors and their families at a Level 1 trauma center in north Minneapolis. Eichenbaum’s clinical observations align with the study’s findings, confirming the profound and pervasive trauma that extends beyond the immediate victims. "You can plainly see the trauma that follows an event like that," she stated. "Not just for the survivors, but for their families. It does not even limit itself to family members. This is an issue that touches entire communities."
The societal and economic implications of gun violence-induced chronic pain are also substantial. David Patterson, an emeritus professor at the University of Washington whose research centers on pain management, points to the study’s revelation of how far the impact of gun violence extends and its significant cost to society. "Chronic pain is a major health problem in itself, and it costs our society billions of dollars because it’s very hard to manage," Patterson remarked. "You can’t cure it; it has to be managed." This underscores the long-term burden on healthcare systems and the economy, as individuals grappling with chronic pain may experience reduced productivity and require ongoing medical intervention.
Back in her dorm room at Brown, Tretta’s words painted a vivid picture of the enduring reality for survivors. She emphasized that medical care does not conclude with hospital discharge; it is a protracted and often lifelong process. "Your body will never be the same as it was before," she stated with poignant honesty. "There’s no time that you can’t feel the 7 or 8 inches of scar tissue running through the middle of your stomach. It’s just a constant physical reminder, because you can’t leave your body." Her experience serves as a stark reminder that the physical wounds of gun violence are not merely acute injuries but can transform into chronic conditions, demanding continuous management and adaptation.
The interconnectedness of physical and psychological well-being in the aftermath of gun violence is undeniable. The phantom pain Tretta experiences is a manifestation of the brain’s persistent response to trauma, demonstrating how deeply ingrained these experiences can become. This phenomenon, along with the diagnosed chronic conditions, highlights the complex interplay between the nervous system, the immune system, and the psychological state of survivors. The chronic pain associated with gun violence exposure can lead to a cascade of secondary health issues, including depression, anxiety, sleep disturbances, and social isolation, further exacerbating the burden on individuals and their communities.
The findings of the Rutgers study, coupled with personal testimonies like Mia Tretta’s, necessitate a broader understanding of the public health consequences of gun violence. It moves beyond the immediate statistics of fatalities and injuries to encompass the long-term, often invisible, suffering of survivors and their loved ones. Addressing this crisis requires a multi-faceted approach that includes not only prevention efforts but also comprehensive support systems for those affected by gun violence. This includes accessible and sustained mental health services, specialized pain management programs, and ongoing physical rehabilitation.
The article was reported by The Trace, a nonprofit newsroom dedicated to covering gun violence in America. Their commitment to shedding light on the multifaceted impacts of gun violence, including its less visible but deeply impactful health consequences, is crucial in fostering a more informed public discourse and driving meaningful change.
The societal cost of gun violence extends far beyond immediate medical expenses. It encompasses lost potential, diminished quality of life, and the erosion of community well-being. As Semenza aptly noted, "The toll of gun violence is much broader than we originally anticipated." By acknowledging and addressing the pervasive issue of chronic pain and other long-term health consequences, society can begin to move towards a more comprehensive and compassionate response to this ongoing epidemic. The lived experiences of survivors like Mia Tretta, though harrowing, provide invaluable insights into the enduring impact of gun violence and underscore the urgent need for sustained efforts to mitigate its devastating reach.