“All of us at anxietycentre.com have experienced debilitating anxiety. But we’ve also overcome it and returned to normal and lasting health. Because we know the hardship anxiety unwellness can cause, we are committed to helping others, with over 30 years of service.” - Jim Folk, President, anxietycentre.com

Chronic Pain Anxiety Symptoms

Jim Folk author
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: October 8, 2019


Chronic Pain Anxiety Symptoms

Pain and chronic pain, are often symptoms of anxiety disorder, including generalized anxiety disorder, social anxiety disorder, panic disorder, and others. Anxiety disorder can also aggravate other pain related conditions such as arthritis, IBS, and fibromyalgia.

To see if anxiety might be playing a role in your chronic pain, you can rate your level of anxiety using our free one-minute instant results Anxiety Test or Anxiety Disorder Test. The higher the rating, the more likely it could be contributing to issues with pain and chronic pain.

This article explains the relationship between anxiety and chronic pain.

Anxiety Chronic Pain Symptoms common descriptions:

  • You have chronic aches, pains, soreness, and tenderness anywhere on or in the body.
  • Your muscles ache and pain persistently.
  • You have persistent muscle tension, stiffness, and pain.
  • Your muscles are constantly stiff and sore.
  • Your joints are always sore, achy, tender, and/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 constantly 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 persistently so bad that you require strong pain medications just to make it through the day.
  • You have persistent pain that causes disruption to a normal lifestyle.

Anxiety-caused chronic pain can persistently affect one area of the body only, can shift and affect another area or areas, and can migrate all over and affect many areas of the body over and over again.

Anxiety chronic pain can come and go rarely, occur frequently, or persist indefinitely. For example, you can have pain and chronic pain once and a while and not that often, have it off and on, or have it all the time.

Anxiety chronic pain can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

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

Anxiety related chronic pain can range in intensity from slight, to moderate, to severe. It can also come in waves, where the chronic pain is strong one moment and eases off the next. It can also persist day after day, change from day to day, or change from moment to moment.

All of the above combinations and variations are common.

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

Many people with anxiety disorder have their sleep disrupted because of chronic pain. Many are also on strong pain medications in an attempt to manage the pain.

Some people become immobilized due to the severity of their episodes of chronic pain, with some people being bedridden because of the intensity and severity of the pain.

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

What Causes Anxiety Chronic Pain Symptoms?

Medical Advisory

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, including this anxiety symptom. If your doctor concludes your symptoms are solely anxiety-related, you can be confident there isn't a medical cause. Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition.

Doctors aren't infallible, however. If you are uncertain about your doctor’s diagnosis, you can seek a second or more opinions. But if all opinions agree, you can be assured anxiety is the cause of this symptom.

Anxiety and the stress it causes is a common cause of chronic pain. There are several reasons why anxiety can cause chronic pain. Some of the most common include:

1. Stress can cause pain.

Research has found that stress, including psychological and emotional stress, can cause issues with pain anywhere on or in the body. While acute stress can cause an analgesic effect (a reduction in pain sensitivity), which we refer to as the pain masking effect (so that pain doesn’t interfere with our ability to defend ourselves when in real danger), chronic stress can cause hyperalgesia (a heightened sensitivity to pain).[1]

Chronic stress can increase pain sensitivity so much that we can experience persistent and even intense pain due to stress and not because of an injury or medical problem. As the degree of chronic stress increases so can the degree and persistence of pain.

Since apprehensive behavior stresses the body, we can experience issues with pain, including chronic pain, merely from anxious behavior. As long as we behave anxiously, issues with pain, including chronic pain, can persist.

2. Pain stresses the body.

Pain is stressful.[1] As the degree of pain increases, so does the body’s level of stress. And as stress increases, so can issues with pain, including chronic pain.

3. Stress increases the body’s 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.[2]

4. Stress causes muscles to tighten.

Persistent muscle tension can cause pain and tenderness. Chronic muscle tension can cause muscles to become painful and sore, which can lead to chronic pain.

When we sense danger, the body produces a stress response, which releases stress hormones into the bloodstream where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat—to either fight with or flee from it—which is the reason the stress response is often referred to as the fight or flight response.[3][4]

chronic pain and anxiety stress response illustration

A part of the stress response changes cause muscles to contract (tighten). Tight muscles make the body more resilient to attack when in dangerous situations. Unfortunately, when stress is caused by anxiety (worry, fretting, fearful thinking) and not by a real physical threat where tight muscles may be beneficial for survival, the body still prepares against danger the same way…by causing muscles to tense and tighten.

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently and/or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering. This can cause the body to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as "hyperarousal").[5][6] A body that becomes hyperstimulated can exhibit all of the changes of an active stress response even though a stress response hasn’t been activated.

Hyperstimulation can cause persistent muscle tension, which in turn can cause muscle aches, pains, tenderness, and soreness. Chronic stress can cause issues with muscle tension-related chronic pain.

Muscle tension problems can also affect the body’s joints, which can cause joint problems and pain, tenderness, soreness, and achiness.

5. Stress adversely affects the body’s nervous system, including its nerves and how they function.

The body’s nervous system is responsible for receiving and sending sensory information to the brain. A main component of the nervous system is specialized cells called neurons (nerve cells), which communicate with each other using an electrochemical process (the combination of electricity and chemistry).[7]

For example, when a nerve impulse is received from one of our senses, such as from the nerve endings in the dermis layer of the skin, neurons relay this nerve impulse information through the nervous system network to the brain for interpretation.

This system of communication works efficiently when the body and nervous system are healthy. Problems can occur, however, when the nervous system becomes stress-response hyperstimulated.

For example, because of their electrochemical properties, neurons are particularly sensitive to stress hormone stimulation. When they become overly stimulated, they can act erratically and more involuntarily than normal, which can cause them to “misreport,” “over-report,” and send “false” nerve impulse information to the brain.[5][8] These anomalies can cause a wide range of unusual sensory-based sensations and symptoms, including those associated with this symptom.

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

Chronic stress can adversely affect any part of the body, including the skin, muscles, nerves and nerve endings, joints, and bones. As a result, body pains can occur anywhere on the body including externally and internally. For some, the pain and tenderness is also accompanied by general fatigue and muscle weakness.

Since each body reacts somewhat uniquely to stress and anxiety, each person’s experience can be somewhat different. And because many anxiety symptoms are “sensory”— having to do with sensations and feelings — there can be a wide range of ways this symptom can be experienced.

Sometimes these types of symptoms are caused by physical problems, such as infections, muscle tension or strain, sensitive nerves, or inflammation. Other times there is no physical cause.

Since the nervous system is responsible for how we receive and interpret sensory information, a stressed nervous system can cause odd and abnormal sensations and feelings even though there is no real physical cause. This is the reason why medical tests can come back normal, yet our sensations and symptoms persist. We FEEL symptomatic even though there isn’t anything medically wrong.

There are other reasons (which we explain in more detail in the Recovery Support area of our website).

I (Jim Folk) experienced pain and chronic pain, too, when I was struggling with anxiety disorder. I know how debilitating it can be.

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

There are some short-term strategies that have proven helpful in reducing and eliminating chronic pain:

1. Reduce stress

Stress can cause and aggravate chronic pain issues. Therefore, reducing stress should be your primary recovery strategy. As the body’s stress diminishes, you should see a reduction in chronic pain. Chapters 4 and 14 in the Recovery Support area have many natural ways of reducing stress.

2. Get good sleep

Research has found that sleep deprivation reduces pain tolerance.[9] Therefore, getting good sleep each night can reduce pain.

Some people with chronic pain, however, have difficulty sleeping because of their chronic pain. In these instances, it’s best to talk with your doctor about ways you can improve your sleep based on the reasons for your chronic pain.

3. Relaxed breathing

Relaxed diaphragmatic breathing stimulates the parasympathetic nervous system, which is responsible for calming the body and reversing the negative effects of stress…both beneficial for reducing pain.

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

A calmer body can lead to a reduction in pain. The vagus nerve interfaces with the parasympathetic control of the heart, lungs, and digestive tract. Vagal tone refers to the activity of the vagus nerve. Increasing vagal tone is associated with increased parasympathetic activity - the nervous system responsible for calming the body - which makes it easier and faster to relax after stress.

4. Regular deep relaxation

Research has found deep relaxation/meditation, especially mindfulness meditation,[10] to be effective in chronic pain management, reduction, and elimination. Deep relaxation/meditation helps the body relax, which reduces stress.

As mentioned earlier, a reduction in stress can also reduce the body’s sensitivity and reactivity to pain, as well as help shut off the negative feedback loops that are often associated with chronic pain. We highly recommend increasing deep relaxation/meditation as a strategy to deal with chronic pain.

Deep relaxation/meditation is also beneficial for reducing anxiety and stress.

5. Healthy diet

An unhealthy diet can cause problems with inflammation. Inflammation is a common cause of chronic pain.

If your pain is coming from inflammation issues, reducing stress, avoiding foods that create inflammation, and eating a diet rich in anti-inflammatory foods can reduce inflammation and pain in time. As the body’s inflammation diminishes, your pain should, as well.  You might be surprised how much of a difference a healthy diet makes.

Certainly, avoiding high sugar foods and stimulants can be especially helpful in reducing inflammation and pain. For more information about adopting a healthy diet, it’s best to work with a Nutritional Science Practitioner, such as Liliana Tosic.

6. Regular exercise

Exercise can reduce pain in several ways, such as increasing overall fitness, increasing muscle strength, reducing body tension, increasing the production of helpful endorphins, increasing aerobic capacity, increasing mental health, and reducing inflammation.

Getting regular mild to moderate exercise can make a difference in the level of pain you feel, 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 just 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.

7. Limit alcohol

Research has found that moderate alcohol consumption can reduce chronic pain for some people.[11][12] But it has also found that more than moderate use can aggravate pain, as well as cause issues with alcohol abuse and dependence.

8. Have a massage

A massage cannot only reduce muscle tension often associated with chronic pain, but it can also reduce stress. A reduction in stress can reduce issues with chronic pain.

9. 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.

10. 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, which can cause an increase in pain the next day.

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.

11. Learn to control your thoughts and attitude about your pain

Numerous studies have found that the attitude you adopt about your pain can make a significant difference not only in the level of pain experienced but also in how you approach life in spite of the pain.[13]

Adopting a positive attitude can not only reduce your level of pain but it can also 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."

12. Distraction

Similar to 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 can increase your quality of life.

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

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

1. Eliminate hyperstimulation (chronic stress)

Anxiety chronic pain is most often caused by chronic stress and its adverse effects on the body (hyperstimulation). Reducing your body’s overall level of stress and giving it ample time to calm down will eliminate anxiety chronic pain…in time. It might take more stress reduction and time than you expect, however. We explain why these types of symptoms can take a long time to subside in spite of our best recovery efforts in Chapters 3 and 4 in the Recovery Support area of our website.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about this symptom.

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 will subside. Therefore, worrying about anxiety chronic pain is pointless…and can even cause it to persist since worry creates anxiety, and anxiety stresses the body.

2. Therapy

Anxiety disorder and its symptoms most often persist because of unidentified and unaddressed underlying factors. Therefore, identifying and successfully addressing those underlying factors is the most important overall.

Since the majority of 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. But if the underlying factors that cause issues with anxiety aren’t addressed, it’s just a matter of time until the body is stressed and symptomatic again.

Rebounds of symptoms and a return to a struggle with anxiety are caused for this very reason: the core issues that cause problematic anxiety haven’t been successfully addressed.

To eliminate issues with anxiety and symptoms once and for all, we need to eliminate the cause of problematic anxiety – the underlying factors that cause issues with anxiety. When you eliminate the cause of the problem, you eliminate the problem and the problem's 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. Research has shown that working with an experienced therapist is an effective treatment for anxiety disorder.[14][15]

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.[16][17]

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


Chronic pain is a common symptom of elevated stress, including the stress anxiety can cause. Jim Folk experienced chronic pain to a severe degree during his 12 year struggle with anxiety disorder.

Can chronic pain cause anxiety?

Anxiety is caused by apprehensive behavior. In this regard, no, chronic pain doesn’t cause anxiety. But 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, a body that’s under stress can cause 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, as well, including anxiety-caused chronic pain.

For a more detailed explanation about all anxiety symptoms, 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 is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.


Additional Resources:


Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including chronic pain and anxiety.


REFERENCES:

1. AHMAD, Asma Hayati, and Rahimah ZAKARIA. “Pain In Times Of Stress.Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2015.

2. 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.

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

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

5. 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.

6. 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.

7. Bear,Connors, Paradiso (2016). Neuroscience: Exploring the brain - Fourth Edition. In Neurons And Glia (pp. 29-53). New York, NY: Wolters Kluwer

8. Hannibal, Kara E., and Mark D. Bishop. “Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation.” Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2014.

9. Finan, Patrick, et al. "The association of sleep and pain: An update and a path forward." Journal Pain, 14, Dec. 2013.

10. 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.

11. Zale, Emily, et al. "Interrelations between Pain and Alcohol: An Integrative Review." Clinical Psychological Review Journal, 25, Feb. 2015.

12. JR, Scott, et al. "Moderate Alcohol Consumption Is Associated with Reduced Pain and Fibromyalgia Symptoms in Chronic Pain Patients." Pain Medicine, 1 Dec. 2018.

13. "6 ways to use your mind to control pain." Harvard Women's Health Watch, April 2015.

14. 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.

15. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

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

17. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.