Can Anxiety Cause Real Physical Pain? What Therapists Want You to Know
Your chest hurts. Your stomach is in knots. Your head throbs. Your muscles ache.
You've been anxious for weeks. Or maybe months. And now your body is screaming at you.
You wonder: is this anxiety doing this? Can worrying actually cause real pain?
The short answer is yes. Anxiety can create real physical pain. Not imaginary pain. Not pain you're making up. Real pain that hurts and affects your life.
Understanding how the brain creates pain helps explain why anxiety and pain are so connected. And knowing this connection opens up new ways to get help through chronic pain therapy and anxiety treatment.
Yes, anxiety can create real pain—here's how
Your brain's main job is to keep you safe. When your brain detects a threat, it activates your nervous system. Your heart races. Your breathing speeds up. Your muscles tense.
This is the fight-or-flight response. And it's supposed to be temporary.
But when you have anxiety, your brain stays in threat mode. It keeps your nervous system fired up, even when there's no immediate danger.
And when your nervous system stays activated for too long, it creates pain.
Here's why: a ramped-up nervous system is a sensitive nervous system. It interprets signals from your body more intensely. Things that wouldn't normally hurt start to hurt. Sensations that would be mild become severe.
Your brain also increases muscle tension when you're anxious. You might not even notice it happening. But over time, tense muscles hurt. They get tired. They create headaches, neck pain, back pain, and jaw pain.
Anxiety also affects your digestive system. It can cause stomach pain, nausea, cramping, and other gut issues. These aren't separate from anxiety. They're part of how anxiety shows up in your body.
The pain is real. It's not in your imagination. Your brain is creating it as part of the anxiety response.
Common types of anxiety-related pain
Anxiety doesn't create the same pain for everyone. But there are some common patterns.
Tension headaches are one of the most frequent types of anxiety-related pain. When you're anxious, you tense muscles in your neck, shoulders, and jaw without realizing it. This tension builds up and creates headaches that feel like a tight band around your head.
Chest pain is another common symptom. Anxiety can cause tightness, pressure, or sharp pains in your chest. This can be scary because it feels like something is wrong with your heart. Most of the time, it's muscle tension and changes in breathing caused by anxiety.
Stomach and digestive pain happen because anxiety directly affects your gut. You might feel nausea, cramping, bloating, or pain that moves around. This connection between anxiety and the digestive system is so strong that researchers call the gut the "second brain."
Muscle pain throughout your body can happen when anxiety keeps your muscles in a constant state of tension. Your shoulders hurt. Your back hurts. Your legs feel sore even though you didn't exercise.
Some people also experience jaw pain from clenching their teeth when they're anxious. Or tingling and numbness in their hands and feet from changes in breathing patterns.
All of these types of pain are real. They hurt. They can be just as limiting as pain from an injury. And they all come from the same source: an anxious nervous system that's working overtime.
Why "just relax" doesn't work
If you've told someone about your anxiety-related pain, you've probably heard some version of "just relax" or "try not to stress so much."
That advice is frustrating. Because if you could just relax, you would.
The problem is that anxiety and pain create a cycle that's hard to break on your own.
You're anxious, so your body tenses up and creates pain. The pain makes you more anxious because now you're worried something is wrong. The increased anxiety makes your nervous system even more sensitive. And the pain gets worse.
Telling yourself to relax doesn't interrupt this cycle. In fact, trying to force yourself to relax often creates more tension.
Your nervous system needs to feel safe before it can calm down. And feeling safe isn't something you can think your way into.
This is why pain and emotion are so connected. When you're stuck in anxiety and pain, both need to be addressed. You can't just work on one and expect the other to disappear.
How therapy addresses both anxiety and pain
Therapy for anxiety-related pain works differently than just trying to relax.
We help your nervous system learn that it's safe. This happens slowly, through experiences, not just through thinking.
One approach is learning to notice anxiety and pain without immediately panicking about them. When you can observe what's happening in your body with curiosity instead of fear, your nervous system starts to calm down.
This might sound simple. But it's not easy. Your instinct is to fight these sensations or try to make them go away. Learning to be present with them without adding fear on top takes practice.
We also work with the different parts of you that show up around anxiety and pain. The part that's scared. The part that's exhausted from dealing with this. The part that just wants everything to be normal again.
When all these parts feel heard and validated, they don't have to work so hard. The tension in your system eases. And as the tension eases, pain often improves.
Therapy also helps you understand the patterns between your anxiety and your pain. When does it get worse? What makes it better? What are you afraid will happen?
These patterns give us important information about what your nervous system needs. And once we understand that, we can give it what it needs to settle down.
Many people find that as their anxiety improves, their pain does too. Not because they learned to ignore it. But because the underlying nervous system activation that was creating both problems has calmed down.
This work overlaps with addressing chronic pain in general. When pain and sadness or depression are connected, we address both. The same is true for anxiety and pain.
Getting help in Lee's Summit or online in Missouri
If anxiety is causing you physical pain, you don't have to figure this out alone.
Therapy can help you understand the connection between your anxiety and your pain. More importantly, it can help you change the patterns that keep both going.
At Aspire Counseling, we work with people throughout Missouri who are dealing with anxiety-related pain and chronic pain conditions. We offer therapy both in person at our Lee's Summit office and through telehealth.
Our approach is grounded in how the brain and nervous system work. We don't dismiss your pain or tell you it's all in your head. We help you understand what's happening and give you tools to change it.
The pain you're feeling is real. The anxiety is real. And there are things we can do to help both.
You can learn more about our approach or reach out to schedule a free consultation. We'll talk about what's going on and whether therapy might help. No pressure, no commitment required.
Call us at (573) 328-2288 or reach out online.
You don't have to keep living like this. Your body is trying to tell you something. We can help you understand what it needs.
Related reading:
Is Chronic Pain All in Your Head? Understanding How the Brain Creates Pain and What Helps
When Pain and Emotion Collide: How Chronic Pain Affects Mood, Sleep, and Mental Health
About the Author:
This post was written by Jessica (Tappana) Oliver, LCSW, founder of Aspire Counseling. Years ago, Jessica regularly saw clients dealing with both anxiety and chronic pain in her own practice. These days, she focuses her clinical work on offering trauma therapy intensives at Aspire, but she remains passionate about the mind-body connection and how therapy can help when anxiety creates physical symptoms. After countless conversations with Adam White, LPC, one of Aspire's chronic pain specialists, she's convinced he's the go-to expert in the Kansas City metro area for treating chronic pain through therapy. This post reflects Adam's approach and expertise in helping people understand and address the connection between anxiety and pain. Adam practices at our Lee's Summit, Missouri location and also offers online therapy throughout Missouri.
