By Jennifer Copley (Last Updated June 22, 2012)
The relationship between anxiety and chronic pain is bidirectional – in other words, anxiety can cause chronic pain and pain can trigger anxiety, creating a vicious circle.
According to the Anxiety and Depression Association of America (2012), there are a number of chronic pain disorders commonly associated with anxiety, including:
- Arthritis: Pain, inflammation, and stiffness in the joints, potentially leading to instability, weakness, and even deformity
- Fibromyalgia: A chronic condition characterized by fatigue, muscle pain, and other unpleasant symptoms
- Migraine: A painful headache typically occurring near the temples or behind an eye or ear, often accompanied by nausea and other unpleasant symptoms; may be preceded by a migraine aura with visual disturbances
- Back pain: Often caused by accident or illness, but more common among anxiety and depression sufferers
- Irritable bowel syndrome: A condition characterized by attacks of constipation or diarrhea, gas, bloating, stomach pain or nausea, and other problems
Anxiety not only increases the risk of suffering from various painful conditions, but can make the pain worse when they occur and increase the likelihood that problems will become disabling.
Treatment of Pain in Anxiety Sufferers
Pain can be more difficult to treat in anxiety sufferers because many anxious people are particularly sensitive to medication side effects or fearful of taking pain medications. Treating anxiety directly can reduce pain in many cases.
Cognitive-behavioural therapy (CBT) is an effective treatment for both anxiety and painful conditions that are worsened by anxiety. In addition, many anxiety and pain sufferers, particularly those who are prone to depression as well, achieve some relief with antidepressant medications such as SSRIs. Mood stabilizing anticonvulsant medications can reduce problematic electrical activity in the brain and hyper-responsiveness, which may also help in some cases. Hypnosis has shown promise in treating some pain syndromes as well. Speak to a doctor to discuss options.
Many anxiety and pain sufferers have also had luck with various complementary treatments such as yoga, acupuncture, or massage. Improving sleep and getting more exercise is also beneficial for the treatment anxiety and pain (check with a doctor before starting an exercise or yoga program, as some conditions preclude certain types of exercise).
A review of research conducted by Nilsson (2008) found that music therapy is often useful for reducing pain in post-surgical patients, which suggests that it might help those with chronic pain as well (see Music Therapy for more information). In addition, there are relaxation techniques such as progressive muscle relaxation, visualization, and calm breathing techniques that can help.
It’s usually best to try a number of complementary therapies to find the ones that work best for you, and reducing overall stress can also help. See How to Reduce Stress for tips on how to do this.
Anti-Inflammatory Diets for Pain Reduction
There are nutritional changes that can help with pain management. Anti-inflammatory diets are particularly beneficial for certain painful conditions such as arthritis.
An anti-inflammatory diet includes lots of fresh produce, foods rich in omega-3 fatty acids such as fish and walnuts, whole grains, lean protein sources (for example, chicken, fish), and anti-inflammatory spices such as ginger and curry. Foods to avoid include refined or processed items (foods made with white sugar, white flour, or white rice), trans fats, red meat, and full-fat dairy products (Doheny, 2008).
Many of the dietary recommendations for reducing inflammation are beneficial for reducing anxiety as well. Anxiety sufferers also tend to do better when they eliminate or reduce their intake of alcohol and caffeine. For information on nutritional approaches to anxiety, see Food Choices to Reduce Anxiety and Natural Anxiety Supplements. For a full list of natural anxiety treatments, see the Anxiety and Panic Disorder page.
This article is provided for informational purposes only and is not intended as a substitute for medical or psychiatric advice. Medical concerns should be referred to a qualified doctor.
- Anxiety and Depression Association of America. (2012). “Chronic Pain.” ADAA.org.
- Nilsson, U. (2008). “The Anxiety- and Pain-Reducing Effects of Music Interventions: A Systematic Review.”AORN Journal, 87(4), 780-807.
- Doheny, K. (Author), Chang, L., MD (Reviewer). (2008). “Anti-Inflammatory Diet: Road to Good Health?” WebMD.com.
- Harvard Medical School. (2010, August 3). “The Pain-Anxiety-Depression Connection.” Health.Harvard.edu.