Chronic Pain Anxiety Symptoms

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 18, 2021

chronic pain anxiety symptoms

Pain, including chronic pain, can be caused and aggravated anxiety disorder. Chronic pain is a common anxiety disorder symptom.

Anxiety disorder can also aggravate other pain-related conditions such as arthritis, IBS, and fibromyalgia.

This article explains the relationship between anxiety and chronic pain.

Common Chronic Pain Symptom Descriptions:

  • You have chronic aches, pains, soreness, and tenderness anywhere on or in the body.
  • Your muscles ache with chronic pain.
  • You have persistent muscle tension, stiffness, and pain.
  • Your muscles are constantly stiff and sore.
  • Your joints are always painful, achy, tender, or stiff.
  • You have a persistent achy feeling in your bones.
  • You have spots on or in your body that are always tender, achy, and sore.
  • Your fingers, toes, hands, feet, arms, legs, back, head, neck, face, and any other area on or in your body always ache and feel sore and painful.
  • You have certain spots on or in your body that are constantly sore and painful, with the pain rarely letting up.
  • Your pain can be so bad that you require strong pain medications to make it through the day.
  • Your body feels racked with pain that disrupts your normal lifestyle.
  • You have a spot or spots on or in your body that constantly feel sore, painful, achy, and tender.

Anxiety chronic pain can affect any part of the body and can migrate and affect different parts of the body over time.

Episodes of chronic pain can be intense for a period and then subside. They can also be constant and unrelenting.

Episodes of chronic pain can precede, accompany, or follow an escalation of other anxiety symptoms or occur by themselves.

Anxiety chronic pain can precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur “out of the blue” and for no reason.

Chronic aches and pains can range in intensity from slight, to moderate, to severe. They can also occur in waves where they are intense one moment and ease off the next.

The intensity of chronic pain can change from day to day, moment to moment, or remain a constant background to your struggle with anxiety disorder.

All of the above combinations and variations are common.

Anxiety chronic pain can seem stronger and more bothersome when undistracted, trying to rest, or when trying to go to sleep. It can also disrupt resting and sleeping.

Many anxious people have their sleep disrupted because of chronic pain. Many are also on strong pain medications to manage the pain.

Some people become immobilized due to the severity of their pain, leading to being bedridden.

When anxiety-caused pain persists 24/7, it’s referred to as “chronic pain.” Fibromyalgia is commonly associated with this type of pain.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including chronic pain symptoms.

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Diagnosis

We recommend all new, changing, persistent, and returning anxiety symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms.

Your doctor will likely take your family and medical history, have you describe your symptoms, and perform a physical exam.

Your doctor might also send you for medical tests, such as a blood test, Glucose Tolerance test, x-rays, ultrasound, or other medical tests to rule out possible medical conditions.

If your doctor asks you to go for tests, it’s best to follow through. In most cases, medical tests will reassure you that you don’t have a medical problem causing your symptoms.

If your doctor concludes your chronic pain is solely caused or aggravated by anxiety, you can be confident there isn’t another cause.

Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition or medication.

Having your doctor’s reassurance can help reduce needless worry.

Can Anxiety Cause Chronic Pain Symptoms?

Yes! Anxiety can create chronic pain and in several ways.

Stress

Apprehensive behavior, such as worry, creates anxiety.

Visit our “What Causes Anxiety” article for more information about the cause of anxiety and anxiety disorder.

Anxiety activates the stress response, also known as the fight or flight response.[1][2] This survival reaction causes many body-wide changes that prepare the body for immediate action.

Visit our “Stress Response” article for more information about the many changes caused by the stress response.

Some of these changes include:

  • Tightens muscles so that the body is more resistant to harm.
  • Increases blood flow to the muscles so that they have the energy needed to fight or flee.
  • Stimulates the nervous system so that we are more sensitive and reactive to danger.

To name a few.

Tight muscles and nervous system sensitivity are common causes of pain.

As long as a stress response is active, it can cause pain for some people.

This type of pain is referred to as “acute” pain as it’s temporary and subsides as the stress response ends.

Due to the many stress response changes, stress responses stress the body. Stress is a common cause of pain.[3]

Chronic Stress (Hyperstimulation)

When stress responses are activated too frequently, such as from overly apprehensive behavior, the body can remain in a state of semi stress-response readiness. We call this state “hyperstimulation,” since stress responses stimulate the body.[4][5]

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body.

Hyperstimulation chronically stresses the body, which can cause persistent muscle tension-related aches and pain.

As long as the body is chronically stressed, it can present chronic pain symptoms.

While acute stress can cause an analgesic effect (a reduction in pain sensitivity), chronic stress can cause hyperalgesia – a heightened pain sensitivity.[3]

Chronic stress (hyperstimulation) can increase pain sensitivity so much that it becomes the sole cause of chronic pain.

As the degree of chronic stress increases, so can the degree and persistence of pain.

Homeostatic Dysregulation

Homeostasis is the term used to describe how the body keeps itself in internal balance despite the ever-changing conditions.

Chronic stress (hyperstimulation) can cause errors in homeostasis, resulting Homeostatic Dysregulation, also known as Dyshomeostasis or Cacostasis.[6]

Homeostatic Dysregulation can result in errors in how the body manages itself, such as causing an increase in respiration; heart rate; blood sugar; muscle tension, spasms, and pain when they aren’t required.

Homeostatic Dysregulation is a common cause of anxiety symptoms that come “out of the blue” and for no reason.

Homeostatic Dysregulation can cause issues with chronic pain.

Nervous System Excitation

The nervous system is particularly sensitive to stress, especially chronic stress.

Chronic stress can cause the nervous system to become overly excited, causing it to behave erratically.[8][9] This erratic behavior can cause chronic neuropathic and phantom pain.

“Overactive nerves” is another term used to describe the cause of chronic pain.

Neuropathic pain is often associated with sharp, stabbing, shooting, and searing pain; tingling sensations, numbness, extreme sensitivity to touch, extreme sensitivity to heat or cold, and worsening pain at night, to name a few.

As long as the body is chronically stressed, it can exhibit symptoms, such as chronic neuropathic pain.

Pain Creates Stress

Just as stress can cause pain, pain is stressful.[3] As the degree of pain increases, so does the body’s level of stress.

Negative cycles often set up where stress causes pain, pain increases stress, an increase in stress causes more pain, and so on.

Stress Increases Sensitivity And Reactivity To Pain

As our overall level of stress increases, we can experience higher and higher degrees of pain due to how stress increases our sensitivity and reactivity to pain.[7]

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Other Causes And Aggravators Of Anxiety Chronic Pain

Inflammation

Stress, especially chronic stress, can cause problems with inflammation.[10][11]

If your stress has been elevated for an extended period, such as from chronic worry, it could be contributing to inflammation problems, resulting in chronic pain.

Inflammation is another common cause of chronic pain.

Medication Side Effects

Some prescription and over-the-counter medications can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

You should talk with your doctor and pharmacist if you suspect a medication might be playing a role in your chronic pain symptoms.

Recreational Drugs

Some recreational drugs stress and stimulate the body, which can cause and aggravate anxiety symptoms, such as chronic pain.

Stimulants

Ingesting stimulants, such as caffeine, stimulates, and stresses the body.

This increase in stimulation and stress can cause anxiety-like symptoms and aggravate existing anxiety symptoms, including chronic pain.

Sleep deprivation

Stress, including anxiety-caused stress, is a common cause of sleep deprivation, such as insomnia.

Sleep deprivation causes an increase in cortisol, a powerful stress hormone.[12] Elevated cortisol stresses the body, which can also cause issues with pain.

Sleep disruption also reduces pain tolerance,[13] which can make pain feel worse.

If your sleep has been regularly disrupted, it can cause problems with chronic pain.

Hyper and Hypoventilation

A change in blood oxygen (CO2) level, either too much (hyperventilation) or too little (hypoventilation), can cause many anxiety-like symptoms, including issues with pain.

If you are frequently under or over-breathing, this could be contributing to your chronic pain.

Low Blood Sugar

Low blood sugar, even if it is low within the normal range, can cause anxiety-like symptoms and aggravate existing anxiety symptoms, which can contribute to chronic pain.

Nutritional Deficiencies

Nutritional deficiencies, such as low vitamin D, low vitamin B12, calcium, and magnesium, can cause and aggravate anxiety symptoms, including contributing to chronic pain.

Dehydration

The body is made up of 60 percent water. If your body is dehydrated, it can cause many anxiety-like symptoms, and aggravate existing anxiety symptoms, including chronic pain.

Hormone changes

Hormones affect the body in many ways. A change in hormones can cause many anxiety-like symptoms, as well as aggravate existing anxiety symptoms.

Hormones also affect each other. An increase in stress hormones can affect other hormones, which could be contributing to chronic pain issues.

Talk with your doctor if you suspect hormones could be a contributing factor in your chronic pain.

The above are just a few of the reasons why anxiety can cause issues with chronic pain.

The Recovery Support area of our website has more detailed information about how chronic stress, the nervous system, and homeostasis can cause issues with chronic pain.

I had pain, and chronic pain, too, when I was struggling with anxiety disorder. It was intense, prolonged, and debilitating. I understand the challenges of chronic pain and how it can impact a person’s life.

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Anxiety Chronic Pain Treatment – Short-Term Remedies

Some short-term strategies have proven helpful in reducing and eliminating anxiety-related chronic pain:

Reduce Stress

Since stress can cause and aggravate chronic pain, reducing stress should be your primary recovery strategy.

As stress diminishes, you should see a reduction in chronic pain.

Visit our article “60 Ways To Reduce Stress Naturally” for many natural and practical ways to reduce stress.

Regular Good Sleep

Since sleep deprivation can cause and aggravate chronic pain and reduce pain tolerance, getting regular good sleep could play an important role in alleviating your chronic pain.

However, some people with chronic pain have difficulty sleeping because of the pain. If this is the case, talk with your doctor about ways to manage pain to improve the quality of your sleep.

Relaxed Breathing

Relaxed diaphragmatic breathing calms the body and reverses the negative effects of stress, both beneficial for reducing pain.

Moreover, relaxed diaphragmatic breathing also tones the vagus nerve. The vagus nerve is responsible for calming the body.

A calmer body can lead to a reduction in pain.

Regular deep relaxation

Deep relaxation, such as mindfulness meditation, is effective in managing chronic pain.[14]

Deep relaxation relaxes the body, which reduces stress.

As mentioned, a stress reduction can also reduce the body's sensitivity and reactivity to pain and help shut off the negative feedback loops that are often associated with neuropathic pain.

We recommend frequent deep relaxation as a healthy and natural way to reduce issues with chronic pain.

Healthy diet

An unhealthy diet can cause problems with inflammation. As mentioned, inflammation is a common cause of chronic pain.

If your pain is coming from inflammation, reducing stress, avoiding foods that create inflammation, and eating a diet rich in anti-inflammatory foods can reduce inflammation and pain.

As the body’s inflammation diminishes, your pain should, as well.  You might be surprised how much of a difference a healthy diet makes.

Avoiding high sugar foods, fast foods, highly processed food, and stimulants can be especially helpful in reducing inflammation and pain.

You will need to maintain a healthy diet for at least 30 days before the benefits can begin to appear.

Also, keeping your body well hydrated can reduce pain, and eating a healthy diet of whole and natural foods can supply the body with important nutrients, both helpful in pain reduction.

Furthermore, eating regularly can stabilize blood sugar, preventing spikes and dips that can contribute to pain sensitivity.

If you’d like personal dietary recommendations and assistance, you can connect with Liliana Tosic, our recommended Nutritional Science Practitioner.

Regular Exercise

Regular exercise can reduce pain in several ways. For instance, it can:

  • Increase your overall fitness
  • Increase muscle strength
  • Reduce body tension and relax tight muscles
  • Increase the production of helpful endorphins
  • Increase aerobic capacity
  • Increase mental health
  • Reduce inflammation

Regular mild to moderate exercise can reduce pain, especially as your body benefits from regular exercise over the long-term.

If your chronic pain has prevented you from exercising, talk with your doctor or physiotherapist about ways to get started. Then, start slowly and build up your stamina over time.

In many cases, stopping exercise because of chronic pain makes pain worse. Even arthritic pain can improve through regular exercise and keeping joints strong and flexible.

Overall, the main takeaway from this strategy is to keep moving.

Avoid or limit recreational drugs

For instance, moderate alcohol consumption can reduce chronic pain for some people.[15][16] However, more than moderate use can aggravate pain and cause issues with alcohol abuse and dependence.

If you believe recreational drugs might be playing a role in your chronic pain, discuss them with your doctor.

Have a massage

A massage not only reduces muscle tension often associated with chronic pain but also reduces stress. A reduction in stress can reduce issues with chronic pain.

Change medication

Some medications can cause issues with chronic pain. If your medication is causing chronic pain, talk with your doctor and pharmacist about switching to a medication that doesn’t cause chronic pain as a side effect.

Don’t overdo it on the good days

Some chronic pain sufferers have good and bad days. On the good days, don’t overdo it. Overdoing it on the good days can cause an increase in pain on the following days.

Know your body and your limits. Then, stay within them even on the good days.

The overall goal is to remain as active as you can every day rather than having short bursts of activity on some days and complete inactivity on others.

Change your thoughts and attitude about pain

Numerous studies have found that the attitude you adopt about your pain can make a significant difference in the level of pain experienced and how you approach life despite the pain.[17]

Adopting a positive attitude can reduce your level of pain and improve your overall quality of life.

"When we're ill, we often tend to become fixated on what we aren't able to do. Retraining your focus on what you can do instead of what you can't will give you a more accurate view of yourself and the world at large," says Dr. Slawsby, assistant clinical professor of psychiatry at Harvard Medical School who works with patients at the Benson-Henry Institute for Mind-Body Medicine at Harvard-affiliated Massachusetts General Hospital.

She advises keeping a journal in which you list all the things you are thankful for each day. "We may have limitations, but that doesn't mean we aren't still whole human beings."

Distraction

Like magnifying the intensity of anxiety symptoms when we focus on them, we also magnify pain when we focus on it.

Focusing your attention away from pain and onto something enjoyable can reduce the level of pain you feel as well as increase your quality of life.

Being distracted by something you enjoy is a great way of shifting focus and reducing pain.

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How To Get Rid Of Anxiety Chronic Pain – Long-Term Strategies

1. Eliminate hyperstimulation (chronic stress)

Hyperstimulation (chronic stress) is a common cause of chronic pain.

Reducing your overall level of stress and giving your body ample time to recover will eliminate anxiety chronic pain…in time.

However, it might take more time than you expect. We explain why it can take a long time to recover from hyperstimulation in the Recovery Support area of our website.

Natural strategies, such as regular deep relaxation, relaxed diaphragmatic breathing, increasing rest, and getting regular good sleep can reduce stress and eliminate hyperstimulation.

Sure, anxiety chronic pain can be bothersome and even debilitating. But again, when your body has recovered from the adverse effects of hyperstimulation (chronic stress), anxiety-related issues with chronic pain subside.

2. Therapy

Behavior creates anxiety. Unhealthy behavior creates unhealthy anxiety.

Consequently, anxiety disorder and its symptoms most often persist because of unidentified and unaddressed underlying factors. Identifying and successfully addressing those underlying factors is the most important work overall if lasting success is desired.

Since most stress comes from behavior (the ways we think and act), addressing the core reasons for anxiety disorder can reduce and eliminate the unhealthy stress that often leads to hyperstimulation and symptoms, including chronic pain.

Keep in mind that eliminating anxiety symptoms doesn’t necessarily mean you’ve overcome issues with anxiety.

Anxiety symptoms are symptoms of stress. Eliminating anxiety symptoms means you’ve eliminated the unhealthy stress that is causing your symptoms.

If the underlying factors that cause anxiety issues aren't addressed, it's just a matter of time until your body is stressed and symptomatic again.

Unidentified and unaddressed underlying factors most often cause rebounds of symptoms and a return to a struggle with problematic anxiety.

To eliminate issues with anxiety and symptoms over the long-term, we need to address the underlying factors that cause problems with anxiety and its symptoms.

When you eliminate the cause of problematic anxiety, you eliminate the problem and its symptoms.

If you have been struggling with anxiety and symptoms, we recommend connecting with an experienced anxiety disorder therapist to help you overcome your anxiety issues.

Working with an experienced anxiety disorder therapist is an effective treatment for anxiety disorder.[18][19]

Moreover, getting therapy via teletherapy, distanced therapy, or e-therapy (telephone or online therapy) is as effective, if not more so, than in-person therapy.[20][21]



Play the clip below for Jim Folk's commentary about the anxiety symptom chronic pain. Jim Folk is the president of anxietycentre.com.


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Can chronic pain cause anxiety?

Anxiety is caused by apprehensive behavior. In this regard, no, chronic pain doesn’t cause anxiety.

However, worrying and fretting about chronic pain can create anxiety since worrying and fretting are examples of apprehensive behavior.

Unfortunately, worrying about chronic pain can create a vicious cycle where worry stresses the body, stress causes issues with chronic pain, chronic pain stresses the body, worrying about chronic pain stresses the body, and so on.

If you find yourself caught in this vicious cycle, we recommend connecting with an experienced anxiety disorder therapist to help you break this cycle.

Overcoming anxiety issues will eliminate its symptoms, including anxiety chronic pain.

For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

For more information:

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including Chronic Pain and Anxiety.

References

1. Selye H. Endocrine reactions during stress. Anesthesia & Analgesia. 1956;35:182–193. [PubMed]

2. "Understanding the Stress Response - Harvard Health." Harvard Health. N.p., n.d. Web. 23 May 2016.

3. AHMAD, Asma Hayati, and Rahimah ZAKARIA. “Pain In Times Of Stress.” Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/.

4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4373764/.

5. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/.

6. Marks, David. "Dyshomeostasis, obesity, addiction and chronic stress." Health Psychology Open, Jan 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193275/

7. Geva, N, et al. “Acute Psychosocial Stress Reduces Pain Modulation Capabilities in Healthy Men.” Advances in Pediatrics., U.S. National Library of Medicine, Nov. 2014, www.ncbi.nlm.nih.gov/pubmed/25250721.

8. Z, Fatahi, et al. "Effect of acute and subchronic stress on electrical activity of basolateral amygdala neurons in conditioned place preference paradigm: An electrophysiological study." Behavioral Brain Research, 29 Sept. 2017, https://www.ncbi.nlm.nih.gov/pubmed/28797601

9. Justice, Nicholas J., et al. “Posttraumatic Stress Disorder-Like Induction Elevates β-Amyloid Levels, Which Directly Activates Corticotropin-Releasing Factor Neurons to Exacerbate Stress Responses.” Journal of Neuroscience, Society for Neuroscience, 11 Feb. 2015, www.jneurosci.org/content/35/6/2612.

10. Sheldon Cohen, Denise Janicki-Deverts, William J. Doyle, Gregory E. Miller, Ellen Frank, Bruce S. Rabin, and Ronald B. Turner. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS, April 2, 2012 DOI: 10.1073/pnas.1118355109

11. Liu, Yun-Zi, et al. “Inflammation: The Common Pathway of Stress-Related Diseases.” US National Library of Medicine, 20 June 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476783/

12. Hirotsu, Camila, et al. "Interactions between sleep, stress, and metabolism: From physiological to pathological conditions." Sleep Science, 28, Sep. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/

13. Finan, Patrick, et al. "The association of sleep and pain: An update and a path forward." Journal Pain, 14, Dec. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046588/

14. Zeidan F, Adler-Neal AL, Wells RE, et al. Mindfulness-meditation-based pain relief is not mediated by endogenous opioids. Journal of Neuroscience. 2016;36(11):3391-3397.

15. Zale, Emily, et al. "Interrelations between Pain and Alcohol: An Integrative Review." Clinical Psychological Review Journal, 25, Feb. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385458/

16. JR, Scott, et al. "Moderate Alcohol Consumption Is Associated with Reduced Pain and Fibromyalgia Symptoms in Chronic Pain Patients." Pain Medicine, 1 Dec. 2018, https://www.ncbi.nlm.nih.gov/pubmed/29546348

17. "6 ways to use your mind to control pain." Harvard Women's Health Watch, April 2015, https://www.health.harvard.edu/mind-and-mood/6-ways-to-use-your-mind-to-control-pain

18. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/.

19. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017, jamanetwork.com/journals/jama/article-abstract/2654783.

20. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.

21. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017, www.psychologytoday.com/us/blog/the-pregnant-pause/201712/advantages-e-therapy-over-conventional-therapy.

chronic pain and anxiety

Pain, including chronic pain, can be caused and aggravated anxiety disorder. Chronic pain is a common anxiety disorder symptom.

Anxiety disorder can also aggravate other pain-related conditions such as arthritis, IBS, and fibromyalgia.

This article explains the relationship between anxiety and chronic pain.

Common Chronic Pain Symptom Descriptions:

  • You have chronic aches, pains, soreness, and tenderness anywhere on or in the body.
  • Your muscles ache with chronic pain.
  • You have persistent muscle tension, stiffness, and pain.
  • Your muscles are constantly stiff and sore.
  • Your joints are always painful, achy, tender, or stiff.
  • You have a persistent achy feeling in your bones.
  • You have spots on or in your body that are always tender, achy, and sore.
  • Your fingers, toes, hands, feet, arms, legs, back, head, neck, face, and any other area on or in your body always ache and feel sore and painful.
  • You have certain spots on or in your body that are constantly sore and painful, with the pain rarely letting up.
  • Your pain can be so bad that you require strong pain medications to make it through the day.
  • Your body feels racked with pain that disrupts your normal lifestyle.
  • You have a spot or spots on or in your body that constantly feel sore, painful, achy, and tender.

Anxiety chronic pain can affect any part of the body and can migrate and affect different parts of the body over time.

Episodes of chronic pain can be intense for a period and then subside. They can also be constant and unrelenting.

Episodes of chronic pain can precede, accompany, or follow an escalation of other anxiety symptoms or occur by themselves.

Anxiety chronic pain can precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur “out of the blue” and for no reason.

Chronic aches and pains can range in intensity from slight, to moderate, to severe. They can also occur in waves where they are intense one moment and ease off the next.

The intensity of chronic pain can change from day to day, moment to moment, or remain a constant background to your struggle with anxiety disorder.

All of the above combinations and variations are common.

Anxiety chronic pain can seem stronger and more bothersome when undistracted, trying to rest, or when trying to go to sleep. It can also disrupt resting and sleeping.

Many anxious people have their sleep disrupted because of chronic pain. Many are also on strong pain medications to manage the pain.

Some people become immobilized due to the severity of their pain, leading to being bedridden.

When anxiety-caused pain persists 24/7, it’s referred to as “chronic pain.” Fibromyalgia is commonly associated with this type of pain.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including muscle symptoms.

Diagnosis

We recommend all new, changing, persistent, and returning anxiety symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms.

Your doctor will likely take your family and medical history, have you describe your symptoms, and perform a physical exam.

Your doctor might also send you for medical tests, such as a blood test, Glucose Tolerance test, x-rays, ultrasound, or other medical tests to rule out possible medical conditions.

If your doctor asks you to go for tests, it’s best to follow through. In most cases, medical tests will reassure you that you don’t have a medical problem causing your symptoms.

If your doctor concludes your chronic pain is solely caused or aggravated by anxiety, you can be confident there isn’t another cause.

Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition or medication.

Having your doctor’s reassurance can help reduce needless worry.

Can Anxiety Cause Chronic Pain Symptoms?

Yes! Anxiety can create chronic pain and in several ways.

Stress

Apprehensive behavior, such as worry, creates anxiety.

Visit our “What Causes Anxiety” article for more information about the cause of anxiety and anxiety disorder.

Anxiety activates the stress response, also known as the fight or flight response.[1][2] This survival reaction causes many body-wide changes that prepare the body for immediate action.

Visit our “Stress Response” article for more information about the many changes caused by the stress response.

Some of these changes include:

  • Tightens muscles so that the body is more resistant to harm.
  • Increases blood flow to the muscles so that they have the energy needed to fight or flee.
  • Stimulates the nervous system so that we are more sensitive and reactive to danger.

To name a few.

Tight muscles and nervous system sensitivity are common causes of pain.

As long as a stress response is active, it can cause pain for some people.

This type of pain is referred to as “acute” pain as it’s temporary and subsides as the stress response ends.

Due to the many stress response changes, stress responses stress the body. Stress is a common cause of pain.[3]

Chronic Stress (Hyperstimulation)

When stress responses are activated too frequently, such as from overly apprehensive behavior, the body can remain in a state of semi stress-response readiness. We call this state “hyperstimulation,” since stress responses stimulate the body.[4][5]

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body.

Hyperstimulation chronically stresses the body, which can cause persistent muscle tension-related aches and pain.

As long as the body is chronically stressed, it can present chronic pain symptoms.

While acute stress can cause an analgesic effect (a reduction in pain sensitivity), chronic stress can cause hyperalgesia – a heightened pain sensitivity.[3]

Chronic stress (hyperstimulation) can increase pain sensitivity so much that it becomes the sole cause of chronic pain.

As the degree of chronic stress increases, so can the degree and persistence of pain.

Homeostatic Dysregulation

Homeostasis is the term used to describe how the body keeps itself in internal balance despite the ever-changing conditions.

Chronic stress (hyperstimulation) can cause errors in homeostasis, resulting Homeostatic Dysregulation, also known as Dyshomeostasis or Cacostasis.[6]

Homeostatic Dysregulation can result in errors in how the body manages itself, such as causing an increase in respiration; heart rate; blood sugar; muscle tension, spasms, and pain when they aren’t required.

Homeostatic Dysregulation is a common cause of anxiety symptoms that come “out of the blue” and for no reason.

Homeostatic Dysregulation can cause issues with chronic pain.

Nervous System Excitation

The nervous system is particularly sensitive to stress, especially chronic stress.

Chronic stress can cause the nervous system to become overly excited, causing it to behave erratically.[8][9] This erratic behavior can cause chronic neuropathic and phantom pain.

“Overactive nerves” is another term used to describe the cause of chronic pain.

Neuropathic pain is often associated with sharp, stabbing, shooting, and searing pain; tingling sensations, numbness, extreme sensitivity to touch, extreme sensitivity to heat or cold, and worsening pain at night, to name a few.

As long as the body is chronically stressed, it can exhibit symptoms, such as chronic neuropathic pain.

Pain Creates Stress

Just as stress can cause pain, pain is stressful.[3] As the degree of pain increases, so does the body’s level of stress.

Negative cycles often set up where stress causes pain, pain increases stress, an increase in stress causes more pain, and so on.

Stress Increases Sensitivity And Reactivity To Pain

As our overall level of stress increases, we can experience higher and higher degrees of pain due to how stress increases our sensitivity and reactivity to pain.[7]

Other Causes And Aggravators Of Anxiety Chronic Pain

Inflammation

Stress, especially chronic stress, can cause problems with inflammation.[10][11]

If your stress has been elevated for an extended period, such as from chronic worry, it could be contributing to inflammation problems, resulting in chronic pain.

Inflammation is another common cause of chronic pain.

Medication Side Effects

Some prescription and over-the-counter medications can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

You should talk with your doctor and pharmacist if you suspect a medication might be playing a role in your chronic pain symptoms.

Recreational Drugs

Some recreational drugs stress and stimulate the body, which can cause and aggravate anxiety symptoms, such as chronic pain.

Stimulants

Ingesting stimulants, such as caffeine, stimulates, and stresses the body.

This increase in stimulation and stress can cause anxiety-like symptoms and aggravate existing anxiety symptoms, including chronic pain.

Sleep deprivation

Stress, including anxiety-caused stress, is a common cause of sleep deprivation, such as insomnia.

Sleep deprivation causes an increase in cortisol, a powerful stress hormone.[12] Elevated cortisol stresses the body, which can also cause issues with pain.

Sleep disruption also reduces pain tolerance,[13] which can make pain feel worse.

If your sleep has been regularly disrupted, it can cause problems with chronic pain.

Hyper and Hypoventilation

A change in blood oxygen (CO2) level, either too much (hyperventilation) or too little (hypoventilation), can cause many anxiety-like symptoms, including issues with pain.

If you are frequently under or over-breathing, this could be contributing to your chronic pain.

Low Blood Sugar

Low blood sugar, even if it is low within the normal range, can cause anxiety-like symptoms and aggravate existing anxiety symptoms, which can contribute to chronic pain.

Nutritional Deficiencies

Nutritional deficiencies, such as low vitamin D, low vitamin B12, calcium, and magnesium, can cause and aggravate anxiety symptoms, including contributing to chronic pain.

Dehydration

The body is made up of 60 percent water. If your body is dehydrated, it can cause many anxiety-like symptoms, and aggravate existing anxiety symptoms, including chronic pain.

Hormone changes

Hormones affect the body in many ways. A change in hormones can cause many anxiety-like symptoms, as well as aggravate existing anxiety symptoms.

Hormones also affect each other. An increase in stress hormones can affect other hormones, which could be contributing to chronic pain issues.

Talk with your doctor if you suspect hormones could be a contributing factor in your chronic pain.

The above are just a few of the reasons why anxiety can cause issues with chronic pain.

The Recovery Support area of our website has more detailed information about how chronic stress, the nervous system, and homeostasis can cause issues with chronic pain.

I had pain, and chronic pain, too, when I was struggling with anxiety disorder. It was intense, prolonged, and debilitating. I understand the challenges of chronic pain and how it can impact a person’s life.

Anxiety Chronic Pain Treatment – Short-Term Remedies

Some short-term strategies have proven helpful in reducing and eliminating anxiety-related chronic pain:

Reduce Stress

Since stress can cause and aggravate chronic pain, reducing stress should be your primary recovery strategy.

As stress diminishes, you should see a reduction in chronic pain.

Visit our article “60 Ways To Reduce Stress Naturally” for many natural and practical ways to reduce stress.

Regular Good Sleep

Since sleep deprivation can cause and aggravate chronic pain and reduce pain tolerance, getting regular good sleep could play an important role in alleviating your chronic pain.

However, some people with chronic pain have difficulty sleeping because of the pain. If this is the case, talk with your doctor about ways to manage pain to improve the quality of your sleep.

Relaxed Breathing

Relaxed diaphragmatic breathing calms the body and reverses the negative effects of stress, both beneficial for reducing pain.

Moreover, relaxed diaphragmatic breathing also tones the vagus nerve. The vagus nerve is responsible for calming the body.

A calmer body can lead to a reduction in pain.

Regular deep relaxation

Deep relaxation, such as mindfulness meditation, is effective in managing chronic pain.[14]

Deep relaxation relaxes the body, which reduces stress.

As mentioned, a stress reduction can also reduce the body's sensitivity and reactivity to pain and help shut off the negative feedback loops that are often associated with neuropathic pain.

We recommend frequent deep relaxation as a healthy and natural way to reduce issues with chronic pain.

Healthy diet

An unhealthy diet can cause problems with inflammation. As mentioned, inflammation is a common cause of chronic pain.

If your pain is coming from inflammation, reducing stress, avoiding foods that create inflammation, and eating a diet rich in anti-inflammatory foods can reduce inflammation and pain.

As the body’s inflammation diminishes, your pain should, as well.  You might be surprised how much of a difference a healthy diet makes.

Avoiding high sugar foods, fast foods, highly processed food, and stimulants can be especially helpful in reducing inflammation and pain.

You will need to maintain a healthy diet for at least 30 days before the benefits can begin to appear.

Also, keeping your body well hydrated can reduce pain, and eating a healthy diet of whole and natural foods can supply the body with important nutrients, both helpful in pain reduction.

Furthermore, eating regularly can stabilize blood sugar, preventing spikes and dips that can contribute to pain sensitivity.

If you’d like personal dietary recommendations and assistance, you can connect with Liliana Tosic, our recommended Nutritional Science Practitioner.

Regular Exercise

Regular exercise can reduce pain in several ways. For instance, it can:

  • Increase your overall fitness
  • Increase muscle strength
  • Reduce body tension and relax tight muscles
  • Increase the production of helpful endorphins
  • Increase aerobic capacity
  • Increase mental health
  • Reduce inflammation

Regular mild to moderate exercise can reduce pain, especially as your body benefits from regular exercise over the long-term.

If your chronic pain has prevented you from exercising, talk with your doctor or physiotherapist about ways to get started. Then, start slowly and build up your stamina over time.

In many cases, stopping exercise because of chronic pain makes pain worse. Even arthritic pain can improve through regular exercise and keeping joints strong and flexible.

Overall, the main takeaway from this strategy is to keep moving.

Avoid or limit recreational drugs

For instance, moderate alcohol consumption can reduce chronic pain for some people.[15][16] However, more than moderate use can aggravate pain and cause issues with alcohol abuse and dependence.

If you believe recreational drugs might be playing a role in your chronic pain, discuss them with your doctor.

Have a massage

A massage not only reduces muscle tension often associated with chronic pain but also reduces stress. A reduction in stress can reduce issues with chronic pain.

Change medication

Some medications can cause issues with chronic pain. If your medication is causing chronic pain, talk with your doctor and pharmacist about switching to a medication that doesn’t cause chronic pain as a side effect.

Don’t overdo it on the good days

Some chronic pain sufferers have good and bad days. On the good days, don’t overdo it. Overdoing it on the good days can cause an increase in pain on the following days.

Know your body and your limits. Then, stay within them even on the good days.

The overall goal is to remain as active as you can every day rather than having short bursts of activity on some days and complete inactivity on others.

Change your thoughts and attitude about pain

Numerous studies have found that the attitude you adopt about your pain can make a significant difference in the level of pain experienced and how you approach life despite the pain.[17]

Adopting a positive attitude can reduce your level of pain and improve your overall quality of life.

"When we're ill, we often tend to become fixated on what we aren't able to do. Retraining your focus on what you can do instead of what you can't will give you a more accurate view of yourself and the world at large," says Dr. Slawsby, assistant clinical professor of psychiatry at Harvard Medical School who works with patients at the Benson-Henry Institute for Mind-Body Medicine at Harvard-affiliated Massachusetts General Hospital.

She advises keeping a journal in which you list all the things you are thankful for each day. "We may have limitations, but that doesn't mean we aren't still whole human beings."

Distraction

Like magnifying the intensity of anxiety symptoms when we focus on them, we also magnify pain when we focus on it.

Focusing your attention away from pain and onto something enjoyable can reduce the level of pain you feel as well as increase your quality of life.

Being distracted by something you enjoy is a great way of shifting focus and reducing pain.

How To Get Rid Of Anxiety Chronic Pain – Long-Term Strategies

1. Eliminate hyperstimulation (chronic stress)

Hyperstimulation (chronic stress) is a common cause of chronic pain.

Reducing your overall level of stress and giving your body ample time to recover will eliminate anxiety chronic pain…in time.

However, it might take more time than you expect. We explain why it can take a long time to recover from hyperstimulation in the Recovery Support area of our website.

Natural strategies, such as regular deep relaxation, relaxed diaphragmatic breathing, increasing rest, and getting regular good sleep can reduce stress and eliminate hyperstimulation.

Sure, anxiety chronic pain can be bothersome and even debilitating. But again, when your body has recovered from the adverse effects of hyperstimulation (chronic stress), anxiety-related issues with chronic pain subside.

2. Therapy

Behavior creates anxiety. Unhealthy behavior creates unhealthy anxiety.

Consequently, anxiety disorder and its symptoms most often persist because of unidentified and unaddressed underlying factors. Identifying and successfully addressing those underlying factors is the most important work overall if lasting success is desired.

Since most stress comes from behavior (the ways we think and act), addressing the core reasons for anxiety disorder can reduce and eliminate the unhealthy stress that often leads to hyperstimulation and symptoms, including chronic pain.

Keep in mind that eliminating anxiety symptoms doesn’t necessarily mean you’ve overcome issues with anxiety.

Anxiety symptoms are symptoms of stress. Eliminating anxiety symptoms means you’ve eliminated the unhealthy stress that is causing your symptoms.

If the underlying factors that cause anxiety issues aren't addressed, it's just a matter of time until your body is stressed and symptomatic again.

Unidentified and unaddressed underlying factors most often cause rebounds of symptoms and a return to a struggle with problematic anxiety.

To eliminate issues with anxiety and symptoms over the long-term, we need to address the underlying factors that cause problems with anxiety and its symptoms.

When you eliminate the cause of problematic anxiety, you eliminate the problem and its symptoms.

If you have been struggling with anxiety and symptoms, we recommend connecting with an experienced anxiety disorder therapist to help you overcome your anxiety issues.

Working with an experienced anxiety disorder therapist is an effective treatment for anxiety disorder.[18][19]

Moreover, getting therapy via teletherapy, distanced therapy, or e-therapy (telephone or online therapy) is as effective, if not more so, than in-person therapy.[20][21]

Play the clip below for Jim Folk's commentary about the anxiety symptom chronic pain. Jim Folk is the president of anxietycentre.com.


Can chronic pain cause anxiety?

Anxiety is caused by apprehensive behavior. In this regard, no, chronic pain doesn’t cause anxiety.

However, worrying and fretting about chronic pain can create anxiety since worrying and fretting are examples of apprehensive behavior.

Unfortunately, worrying about chronic pain can create a vicious cycle where worry stresses the body, stress causes issues with chronic pain, chronic pain stresses the body, worrying about chronic pain stresses the body, and so on.

If you find yourself caught in this vicious cycle, we recommend connecting with an experienced anxiety disorder therapist to help you break this cycle.

Overcoming anxiety issues will eliminate its symptoms, including anxiety chronic pain.

For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

For more information: