Can Stress Cause Pain?

Pain is one of the most common reasons people visit the doctor, with an estimated 20–30% of U.S. adults—nearly 75 million people—living with chronic pain. 

Despite a wide range of available treatments, many people continue to struggle with managing their pain, with nearly half reporting that they don’t achieve adequate relief.

But what if the answer to managing pain isn’t just about medications or physical therapy? What if stress plays a larger role than we realize? In this blog, we’ll delve into how stress can actually contribute to pain and how understanding this relationship might hold the key to improving treatment outcomes.

The Stress Pain Cycle

Did you know that stress doesn't just affect your mind—it can take a serious toll on your body too? According to the American Institute of Stress:

• 33% of people report experiencing extreme stress

• 77% feel stress impacting their physical health

• 73% experience stress that affects their mental well-being

• 48% struggle with sleep because of stress

  
  

Unfortunately, for many Americans, stress levels aren’t improving—they’re getting worse.

What’s even more concerning is that both stress and pain are among the top reasons people seek medical care. This led us to ask: Is there a deeper connection between the two? To understand more, we dove into the science behind stress and pain to see how, or if, these two factors are truly related.

Keep reading to discover what we found.

Stress And Your Brain

When you visit the doctor for pain, the typical approach is to identify the source. Your doctor will ask you to describe where it hurts, and from there, they’ll try to find the cause—whether it's an injury, muscle strain, or underlying condition. The goal is simple: treat the problem at its source to alleviate the pain.

But what happens when this approach doesn’t work?

What if doctors can’t pinpoint a specific area of your body that’s causing the pain? Or what if all the imaging and tests come back normal, but you are still super sore?

This is where stress can complicate things.

When stress becomes chronic, it can interfere with how your brain processes pain, leading to persistent discomfort even without a clear physical cause. In the next section, we’ll explore how stress impacts the brain and why it might be contributing to your pain in ways you might not expect.

Underlying Causes Of Pain

In recent years, more and more patients are presenting with cases where the source of their pain is almost impossible to identify, and it's causing doctors to rethink how chronic pain is understood and treated. Traditionally, doctors relied on imaging and medication to identify and address pain. But now, there's growing recognition that the root cause of some pain may not be physical at all—it's the brain.

Pain and stress both play vital roles in the body’s ability to respond to its environment. They serve protective functions, helping us avoid injury or danger. However, when pain or stress become persistent, they can turn "maladaptive," meaning they no longer serve a beneficial purpose. Instead, they can have a negative impact on our health, contributing to ongoing discomfort and even compromising overall well-being.

Chronic Stress and Cortisol

Imagine you're walking in the woods and suddenly spot a bear. Your body's stress response kicks into high gear. This acute stress triggers your autonomic nervous system, controlled by your brain, and sends signals that raise your blood pressure. Blood is diverted from your gastrointestinal system to your muscles and brain, preparing you to either fight or flee. Your brain tells your legs to run, and in this moment, that stress is life-saving. You escape the bear.

But what happens when the stress isn't so temporary? What if the source of stress is your job, the economy, a sick family member, or constant worries about the future? When your body is in a perpetual state of "running away from the bear," day after day, this is when stress shifts from being helpful to harmful. Chronic stress, unlike the acute kind, becomes maladaptive—it doesn't protect you; it wears you down.

This constant state of heightened stress, especially when it persists over time, can significantly impact your body, including contributing to persistent pain, particularly in the lower back.

How Stress Triggers Pain: The Fight or Flight Response

The brain is at the heart of both stress and pain, constantly responding to the physical and psychological stressors we encounter in our daily lives. These stressors can lead to a range of neural and hormonal reactions which can be either adaptive or maladaptive, depending on how your body responds.

When stress hits, your body goes into a series of responses. You might notice changes in your pain threshold, how you move, or even your body temperature (stress sweating anyone?). This is your body's "fight or flight" response in action.

In these moments, your adrenal glands release a hormone called cortisol, which helps your body react to the stressor. However, when stress becomes chronic, the continuous release of cortisol can contribute to ongoing pain and discomfort, especially in your lower back. Doctors can even measure cortisol levels in your saliva to assess how much stress your body is under.

The Delayed Effects Of Stress On Your Body

When stress hits, your body responds almost instantly, triggering a cascade of reactions. Within seconds of detecting a stressor, your body’s acute stress mediators spring into action, either escalating or dampening the stress response as needed to prepare for a "fight or flight" scenario.

However, what’s fascinating is that the effects of stress don’t always end with those immediate responses. Even hours after exposure to stress, some delayed reactions still unfold in the brain. Research, including studies conducted on rats, shows that these delayed effects can persist for up to 28 days following a stressful event. These lingering responses play a critical role in helping your body recover and return to baseline, while also helping you retain important information to better handle similar stressors in the future.

But how does this delayed stress response tie into pain? That’s what we’ll explore next.

Stress and Pain: The Surprising Role Stress Plays in Numbing Pain

1. Analgesia

It may sound counterintuitive, but the same stress response that prepares our bodies for danger can actually alter how we experience pain. Stress can affect pain in two surprising ways, one of which is through analgesia—a temporary numbing of pain.

In certain situations, stress acts almost like a painkiller. Take the example of a zebra being attacked by a lion. The zebra goes into shock, and for a period, it appears to be dead. This is no coincidence. The zebra’s body is in a state of analgesia, meaning it doesn’t feel any pain during the attack. This response allows the zebra to survive: once the lion leaves, it can regain consciousness and escape to safety.

Have you ever experienced something similar? Perhaps you’ve hurt yourself, only to feel no pain at all in the moment. It’s not until later, when you’re safely with a doctor or a loved one, that the pain sets in. This delayed pain response is your body’s natural analgesic response to stress—an essential survival mechanism that temporarily numbs pain to allow you to focus on getting to safety.

2. Hyperalgesia: Stress That Makes Pain Worse

While stress can sometimes numb pain, it can also have the opposite effect—making pain feel even more intense. This is known as hyperalgesia, a condition where stress actually increases our sensitivity to pain.

Research has shown that stress can heighten pain perception. For instance, subjects who completed a difficult math problem reported feeling more pain than those who didn’t have to solve the problem. In animal studies, both acute and chronic stress have been shown to increase pain sensitivity. In fact, rats exposed to chronic stress experienced heightened pain sensitivity for up to 28 days.

Even more intriguing, chronic stress seems to interfere with the effectiveness of pain-relieving drugs. Studies have found that individuals under chronic stress exhibit a reduced response to morphine, suggesting that the body’s opioid systems may become less responsive under prolonged stress.

Who knew that tackling a math problem could literally be painful?

Inflammation, Stress, and Low Back Pain: The Vicious Cycle

Chronic stress doesn’t just affect how we feel emotionally—it can also lead to physical pain, especially in the form of inflammation. This is particularly true for conditions like low back pain. The constant strain on your body from either excessive physical activity or prolonged inactivity can lead to what’s called allostatic overload, where your body’s stress response system is in overdrive.

When you're exposed to continuous or unpredictable stress, your body reacts by triggering an inflammatory response. Inflammation is typically part of the body's natural healing process, helping to protect and repair tissues. But when stress keeps sending the message that the body is in danger, the inflammatory response never really shuts off.

This chronic inflammation can leave you vulnerable to persistent pain, especially in the lower back. It’s like your body is constantly “on alert” to heal—even when it doesn’t need to, increasing your risk of experiencing pain. Over time, this cycle of stress and inflammation can fuel and intensify your low back pain, creating a vicious loop that’s hard to break.

The Consequences Of Chronic Stress On The Body

Stress means different things to different people. What causes stress in one person may be of little concern to someone else. Some people are better able to handle stress than others. Some people have developed appropriate coping mechanisms over the years while others may not have learned those tools.

It is also important to remember that not all stress is bad. Our bodies are designed to handle small doses of stress, but they are not equipped to handle long-term, chronic stress without ill consequences.

Some Ways That Stress Can Affect Your Body

Stress can take a serious toll on your body in ways you might not even realize. It's not just about feeling overwhelmed mentally—stress shows up physically, too. For example, research has shown that stress can worsen conditions like gastro-oesophageal reflux and increase musculoskeletal pain, particularly in people with chronic conditions like fibromyalgia or lower back pain.

But the effects of stress don't stop there. Here's a glimpse at some other ways stress can manifest in your body:

• Low energy – Stress can leave you feeling drained, even when you're getting enough sleep.

• Headaches – Stress is a common trigger for tension headaches or migraines.

• Digestive issues – Stress can cause stomach discomfort, including nausea, diarrhea, and constipation.

• Aches and pains – Stress leads to muscle tension, which can cause discomfort or even trigger chronic pain.

• Chest pain and rapid heartbeat – When stress kicks your heart rate up, it can feel like your body is on high alert, even when there's no real danger.

  
  

These physical symptoms are all signals from your body that stress isn't just a mental burden—it’s affecting your overall health in profound ways.

We Are In A Mental Health Crisis

Mental health continues to be a critical issue affecting millions of people worldwide. In the United States, mental health challenges are widespread, with the following statistics highlighting the scope of the issue:

• Anxiety disorders are the most common mental health condition in the U.S.

• Nearly 20% of Americans are affected by an anxiety disorder.

• Over 30% of adolescents between the ages of 13 and 18 experience anxiety disorders.

• Reports of elevated levels of stress and mental health challenges are still on the rise, affecting individuals across the nation.

  
  

In response to these growing concerns, mental health treatment is becoming more prevalent. According to the CDC, the percentage of adults receiving mental health treatment has steadily increased from 19.2% to 21.6% over recent years.

How Stress Affects Low Back Pain

We already know that stress can make us more sensitive to pain and even increase inflammation, which tightens our muscles and worsens discomfort. It's clear that the more stressed we become, the more intense our low back pain can feel.

But it's not just internal stress that affects our pain levels—our environment plays a significant role too. For example, studies show that for every 1% increase in unemployment, there’s a corresponding rise of about 770,000 new cases of low back pain. This suggests that economic stress can have a direct impact on physical health, particularly when it comes to chronic pain.

Other factors, like isolation, depression, and loneliness, also contribute to heightened pain perception. These emotional stressors can not only intensify the physical experience of pain but can also create a cycle of discomfort that feels harder to break.

Ways To Manage Stress And Back Pain

1. Exercise

Exercise is one of the most effective tools you have for managing both stress and low back pain. Physical activity signals to your body that the stressor of the day is over, helping you transition into a more relaxed state for the evening. Whether it’s going for a walk after work or engaging in a more intense workout, exercise has the power to shift your body’s response to stress.

Beyond providing a mental break, exercise also helps reduce stress hormones like cortisol, while boosting endorphins—your body’s natural painkillers. These changes not only help alleviate stress but can also ease muscle tension and lower your perception of pain, making it an essential part of managing chronic low back pain.

2. Sleep

Sleep is often underestimated, yet it plays a critical role in helping our bodies recover. Research has shown that while we sleep, our immune system increases the production of disease-fighting proteins, which are essential for healing and overall well-being.

That said, sleeping with chronic pain, especially low back pain, can be difficult. The good news is that there are practical strategies to improve your sleep quality, even with ongoing pain. In fact, we’ve covered some useful tips for sleeping with low back pain in our previous blog, How to Sleep with Low Back Pain. Implementing these strategies can make a world of difference, helping you get the restful sleep your body needs to heal and better manage pain.

3. Meditation

Meditation might seem unconventional to some, but research has shown it can be a powerful tool for pain relief. Even something as simple as slow, paced breathing has been linked to reduced pain levels. Studies reveal that meditation activates neural pathways in the brain that not only make it less sensitive to pain but also enhance the brain's natural pain-reducing mechanisms, including its own opioids.

If you're living with chronic pain, incorporating meditation into your routine could be worth exploring. It's a practice that taps into your brain's natural ability to manage discomfort—often with lasting benefits.

Conclusions - Can Stress Cause Pain?

Pain affects our bodies in complex ways, and what we’ve covered here is just the surface. Recognizing the strong connection between pain and stress is crucial, especially when it comes to managing musculoskeletal conditions like low back pain.

Treating low back pain requires more than just addressing the symptoms—it’s essential to understand the underlying causes, including stress, that contribute to the pain.

Research has shown that integrating stress-relieving therapies into your treatment plan, as part of a holistic biopsychosocial approach, can make a significant difference in long-term pain management. By treating the whole person—not just the pain—you can achieve more effective and lasting relief.