So often we see patients who suffer from anxiety, depression or have extremely stressful lives. These patients often complain of neck and back pain, usually more severe than their testing would indicate. They are not malingering, nor are they exaggerating. They really feel this pain.

Let’s talk……

The body’s reaction to stress varies with each individual, but is generally a variation of the “fight or flight” response we all have to any threat. This includes an increased heart rate and a tightening of all muscles as the body prepares for a reaction. This tightening of muscles is frequently the cause of back and neck pain, causing tension, pain and stiffness.
Anxiety often causes the same reaction though there is only a perceived threat. Worry, fretting or fearfulness can lead to muscle tension but also the feeling that if you move the pain will get worse. Therefore the patient will unnecessarily limit activities of daily life including exercising and leisure activities. This will weaken the muscular support of the spine and also lead to depression as their world gets smaller due to a fear of activity.
Depression is often the cause, or the result, of back or neck pain. Even a very minor back problem can become debilitating for someone who is unable, or unwilling, to exercise and who is given strong medications and told to “rest “after an injury. We all know that pain is increased with inactivity and definitely becomes the center of your existence if you have nothing else to do, or think about.
What a patient does about the stress, anxiety or depression will have a direct effect on their recovery or their pain level. Once any chance of a neurological injury is ruled out, the patient needs to move. Exercise will loosen tight muscles, increase endorphins and add to a feeling of wellbeing. Controlling the stress and anxiety will immediately improve the patient’s outlook and therefore, their discomfort.
A good night’s sleep is key. Consistent sleep and wake times, avoidance of caffeine and a temperate room with no distractions, like a TV or telephone, will all work toward getting proper rest.
Proper nutrition is also important. Again caffeine can be a culprit along with alcohol and sugar in causing anxiety, mood swings and periods of exhaustion.
Talk to your physician and see what lifestyle changes would make a difference in your pain level. As you can see, a happy, well-rounded individual is much more likely to be painfree, or to tolerate and recover more quickly from an injury.


  • Pereira MG, Roios E, Pereira M. Functional disability in patients with low back pain: the mediator role of suffering and beliefs about pain control in patients receiving physical and chiropractic treatment. Braz J Phys Ther. 2017 Jul 3; PubMed PMID: 28716365
  • Marshall PWM, Schabrun S, Knox MF. Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain. PLoS One. 2017;12(7):e0180788. PubMed PMID: 28686644


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Last modified: October 24, 2017

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