Anxiety, Pain, and Chronic Pain
In a series of online polls we conducted, 79 percent of respondents said they experienced pain as a result of their anxiety. Of this, 14 percent reported anxiety related pain was their worst symptom.
Anxiety-related pain, including chronic pain, are common symptoms of anxiety. In some cases, anxiety-related pain can be so debilitating that strong pain management medication is required just to function throughout the day, or worse, a person is bedridden because of the severity of their pain.
There are many reasons why anxiety can cause pain. For more information, you can read our “Chronic Pain Anxiety Symptoms” article.
Recent research has found some interesting correlations between anxiety (and other mental health issues) and pain. For instance, that chronic pain sufferers were likely to have anxiety. The press release for this research is below.
Moreover, that anxiety (and other mental health issues) are risk factors for pain, and especially in teenagers. You can read the article “Living In Fear: Mental Disorders As Risk Factors For Chronic Pain In Teenagers” for more information.
Fortunately, there is a lot we can do to mitigate these risk factors and to eliminate anxiety-caused pain, including anxiety-caused chronic pain. We explain more about this in the Recovery Support area of our website.
Chronic Pain Sufferers Likely To Have Anxiety
Patients coping with chronic pain should also be evaluated for anxiety disorders, according to new research published in General Hospital Psychiatry.
"I think [health care] providers are more aware of the common occurrence of depression in patients with chronic pain, and there has been less of an emphasis on anxiety," said lead author Kurt Kroenke, M.D., professor of medicine at Indiana University in Indianapolis.
In the new study, researchers evaluated 250 primary care patients who were being treated at a Veterans Medical Center in the Midwest. All patients had moderate to severe chronic joint or back pain that had lasted at least 3 months despite trying pain medications.
The participants were screened for five common anxiety disorders: generalized anxiety, characterized by persistent worry; panic, or sudden, repeated attacks of fear; social anxiety, characterized by overwhelming anxiety in everyday social interactions; post-traumatic stress, or a repeated feeling of danger after a stressful event; and obsessive-compulsive disorder, characterized by repeated thoughts or rituals that interfere with daily life. They were also screened for health-related quality of life issues, such as fatigue, sleep habits, and work productivity.
The study found that 45 percent of the pain patients screened positive for at least one or more of the common anxiety disorders. And those who had an anxiety disorder also reported significantly worse pain and health-related quality of life than patients without a disorder.
"It is important to note that patients in our study screened positive for an anxiety disorder but not all would have a full-blown anxiety disorder if they had a diagnostic psychiatric interview," said Kroenke. "Some may just have anxiety symptoms and not all would warrant active treatment. However, probably at least 1 in 5 might have some type of anxiety disorder."
The researchers also found that it was common for the five different types of anxiety conditions to occur in combination with each other and with depression.
"Psychological comorbidities are common in patients with chronic low back pain and other studies have also shown a high prevalence of depression, anxiety and other psychological conditions," said pain expert Roger Chou, M.D., an assistant professor of medicine at Oregon Health & Science University.
Chou added that the guidelines on evaluating and managing lower back pain do recommend clinicians assess patients for psychological factors that may be contributing to a poorer prognosis and address them with appropriate treatments.
"Many patients benefit from cognitive behavioral therapy to help them in coping with the pain and related anxiety," Chou continued. "Just throwing pain medications at someone like this doesn't tend to be very effective since you're not dealing with an important driver of the pain."
Kroenke K, Outcalt S, et al. Association between anxiety, health-related quality of life and functional impairment in primary care patients with chronic pain. General Hospital Psychiatry, 2013
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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.
For more information about our Anxiety Counseling option; our Available Anxiety Therapists; to Book An Appointment with one of our anxiety therapists; common Anxiety Signs and Symptoms; common Anxiety Attack Symptoms; the symptoms of panic attack disorder; anxiety Recovery Support area; information about Anxiety; and our Anxiety 101 section; or click on the appropriate link or graphic below:
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Authors: Jim Folk, Marilyn Folk, BScN. Last updated February 25, 2019.