Can Stress Cause Physical Pain?

As we wrap up Stress Awareness Month, let’s talk about something that surprises many of my patients: stress can actually cause physical pain. I see it all the time in my practice. I’ve had plenty of patients come in with back pain, jaw tightness, or digestive issues, and when we really dig in, a common thread is often stress. Your body doesn’t just feel stress emotionally. It reacts physically. When you’re under stress or pressure, your nervous system flips into “fight or flight.” That’s survival mode, and it puts tension on everything from your muscles to your gut. This can lead to muscle tension, headaches, stomach issues, and even chest pain.

When you’re stressed, your brain kicks off a full-body response. The hypothalamus sends signals that tell your adrenal glands to release adrenaline and cortisol. Those are your “go-go-go” hormones. They get your heart pumping, your muscles primed, your breath shallow because your body thinks it’s preparing for battle.

That’s helpful short-term, but if you’re stressed all the time? You’re constantly bathed in those chemicals. Your muscles stay tense. Your digestion slows or overreacts. Even your blood thickens a bit because your body is preparing for injury. That chronic load is what starts turning stress into physical pain.

Types of Physical Pain Caused by Stress

Stress can manifest physically in a lot of sneaky and silent ways. When stress hormones like adrenaline and cortisol increase, this can cause your muscles to contract and tighten. If the stress is chronic, your muscles may remain tense for long periods, leading to pain and discomfort. Here are some ways that your body can show stress:

• Muscle tension: Most often in your neck, shoulders, and lower back. I’ll often ask patients, “Do you feel like you’re carrying your stress in your body?” A lot of them say yes, but they don’t realize how much until they stop and think about it.
• Headaches and migraines: Tension in your scalp and jaw muscles can trigger dull, aching headaches or migraines.
• Stomach discomfort: Your gut and your brain are deeply connected. Stress can slow digestion, cause cramps, bloating, acid reflux, heartburn, nausea, and even IBS flare-ups.
• Chest pain: This is a big one. Stress can cause tightness in your chest that mimics heart palpitations. Always get that checked out but don’t be surprised if it’s caused by anxiety.
• Fatigue: When your system is running full throttle all the time, your body wears out. Chronic stress can make you feel heavy and drained, like you haven’t rested even after a full night’s sleep.
• Joint pain: Stress can trigger inflammation, which flares up conditions like arthritis.

There are early signs if you know what to look for. Jaw clenching. Trouble sleeping. Racing thoughts. That vague “buzz” of tension in your body. Those are red flags of your body whispering that stress is taking a toll before it starts screaming with pain.

Health Impacts of Stress-Related Pain

Here’s where the Doctor of Osteopathic Medicine (DO) in me really wants to slow down and zoom out. Because when we talk about stress, we’re not just talking about something that “lives in your head.” Stress shows up in your fascia, your joints, your breath, and even your digestion. It’s everywhere.

Muscle Tension and Chronic Pain

When stress becomes chronic, it pushes your body into a constant state of alert, which is what we call “sympathetic overdrive,” or being stuck in fight-or-flight mode. That survival mode was meant to help us escape a short-term threat. But when your body never gets the memo that it’s safe again, that stress response keeps cycling. And that’s when pain becomes more than just a symptom—it becomes your new baseline.

Long-term muscle tension can become chronic pain conditions like tension headaches, TMJ, and even fibromyalgia. Stress drives up cortisol, which promotes inflammation. Over time, that inflammation contributes to heart disease, joint pain, and gut problems.

Mental Health Strain

Mentally, it wears you down. Chronic pain can lead to anxiety, depression, burnout—and those things feed right back into the stress cycle. It’s like a loop: stress causes pain, pain causes stress, and you feel stuck. Chronic stress can also slow down the body’s healing processes, making it harder for wounds or injuries to recover fully. To learn more about how your brain reacts to stress, watch our neurologist explain this connection:

Neurologist Explains the Stress-Pain Connection

Stress or Something More? How to Decode Your Pain Signals

This can be very hard or simple to tell, based on how “in tune” you are with your body. You have to do a mental check with yourself and ask if you have been stressed lately.

Start with a self check-in. Ask yourself:

• Have I been under more stress than usual?
• Is this a type of pain I’ve had before during stressful times?
• Do I carry tension in this part of my body?

If the pain lines up with stress patterns—tight neck, digestive issues, tension headaches—it could be stress-driven. But if it feels unfamiliar, sudden, sharp, or persistent in a way that’s new? Let’s not guess. That’s when you need a proper medical evaluation. Never assume and always rule things out first, especially when it comes to chest pain, severe headaches, or neurological symptoms.

Effective Stress Management Techniques

Stress can have a widespread impact on the body, and these physical symptoms often make the cycle of stress even more challenging. When you experience physical pain, it can worsen your stress, creating a feedback loop. I always tell patients: don’t wait until you’re burned out to take care of yourself. Stress management isn’t about fixing a crisis—it’s about giving your body space to reset before it breaks down. To combat stress-related pain, consider these techniques:

• Deep Breathing & Mindfulness Meditation: Promote relaxation and reduce stress hormones.
• Exercise & Yoga: Boost mood-enhancing chemicals like dopamine.
• Journaling: Identify stressors and celebrate happy moments.
• Gratitude Practice: Shift your focus toward positivity.
• Social Connection: Lean on family and friends for emotional support.
• Improved Sleep Hygiene: Elevate your rest and recovery.

Some of my personal favorite stress relievers include yoga, spending time with my family, and practicing good sleep hygiene. I’ve learned that stress isn’t something to “push through.” It’s something to respect. Because when I listen to my body, it performs better. And I show up better for my patients.

When Stress Relief Isn’t Working: How to Break the Stress-Induced Pain Cycle

If you’ve tried some of the self-management tools our neurologist has approved—breathing, movement, mindfulness—and those haven’t alleviated your symptoms, it’s time to bring in help. Or if you’re not sure what’s causing the pain in the first place, that’s a big sign too.

Start with someone who takes a whole-body approach. That might be a physiatrist like me or a primary care doctor who understands the musculoskeletal system. Depending on what we find, I might bring in other specialists, like a physical therapist, a GI doctor, a neurologist, or even a pain management team, to create tailored treatment plans and make sure we aren’t missing anything.

If you’re feeling overwhelmed or hopeless, please reach out to a mental health professional. There is no shame in needing support. Stress is real. Pain is real. And so is healing.