Physical Symptoms

How Anxiety Causes Back Pain: And How to Stop It

  • Anxiety, especially chronic anxiety, commonly leads to back pain
  • Muscle tension may be the primary cause, but there are other supplementary anxiety symptoms that could also cause back pain
  • Simple lifestyle changes can reduce some of the back pain
  • One simple change: posture, which can be affected by anxiety in several ways
  • Eliminating back pain from anxiety, specifically, traditionally requires anxiety treatments
Wendy M Yoder, Ph.D.

Written by

Wendy M Yoder, Ph.D.

Last updated February 12, 2021

How Anxiety Causes Back Pain: And How to Stop It

Pain is extremely disruptive, with back pain easily one of the most common types of pains to experience. If you're prone to anxiety, then it's possible that you've been suffering with regular back pain for years as a result of it.

Back pain from anxiety is common, and while it is certainly not the main cause of back pain, it is a reason that some people end up getting help for their anxiety. So what causes back pain, and what can be done about it? We explore these thoughts in this article.

Causes of Anxiety Related Back Pain

There are many different issues that can lead to back pain, and it is helpful to speak with a doctor to determine what your cause may be. When anxiety contributes to back pain, it is believed thatthe cause of back pain from anxiety is mostly secondary - meaning that anxiety isn't literally causing back pain, but anxiety is causing behaviors that lead to back pain. 

There are many theories that describe a situation where back pain may be directly caused by anxiety. The most common is theory is that anxiety, which causes muscle tension, may be tensing muscles in the upper or lower back, and that that muscle tension causes pain in anxiety sufferers. 

Massage therapists will tell you that their most stressed clients often have knots in their muscles, especially in their shoulder and upper back, so anxiety-related back pain really does exist.

But anxiety may also be causing separate issues that simply lead to back pain. These include:

  • Changes in Posture Anxiety can cause people to change their behaviors and posture, including the way they sit, what they do when they sit, whether they slouch, and so on. Changes in posture - especially when combined with the muscle tension from anxiety - can cause the muscles to be in uncomfortable positions and ultimately lead to back pain.
  • Inactivity Anxiety may also change people's physical activity levels. Activity plays a direct role in back pain, and healthy physical activity tends to make the back more mobile and less receptive to general aches and pains. If someone reduces their activity levels because of anxiety, it is possible that will lead to back pain. Sometimes the two issues develop together, however - inactivity can lead to anxiety, which may indicate that they are separate conditions with similar contributing factors.
  • Hypersensitivity Another issue related to anxiety is hypersensitivity. Those with anxiety tend to experience physical sensations more than those without anxiety. As such, mild back pain - the type of back pain that normally wouldn't change your activity levels - could feel more severe and be harder to ignore, which in turn would lead to adjustments that may contribute to further back pain.

Anxiety isn’t believed to cause severe back pain. But it’s also important to remember that there is often a back pain cycle. Those with greater perceived back pain (either because the back pain is severe or because they are hypersensitive to the pain) are more likely to over-adjust in an attempt to avoid the pain. Chiropractors see this often. A patient with mild back pain will make their back pain worse because they're constantly walking, sitting, or twisting in ways that are unnatural in an attempt to reduce that back pain.

So while anxiety may not cause severe back pain on its own, a person’s reaction to their anxiety related back pain could potentially be contributing to more severe pain.

Similarly, some people experience further anxiety as a result of their back pain, regardless of whether the initial back pain was caused by anxiety. Since anxiety can cause back pain because of muscle tension, posture changes, etc., this may also make the back pain worse. While it may not have been initially caused by anxiety, anxiety contributed to the back pain cycle.

How to Stop Anxiety From Causing Further Back Pain

Under the assumption that your back pain is caused by anxiety, treating that back pain does require a focus on the pain itself. Unfortunately, while treating anxiety can reduce your back pain in the long term (more on this later), breaking the cycle of back pain depends in large part on your ability to also fight the back pain itself. Consider the following tips:

  • Stretch Stretching is incredibly important. You need to keep the muscles stretched and nimble to prevent further pain. Make sure you're stretching regularly in order to avoid any "freezing" of the muscle that may create pain. Examples of this type of stretching include lying knee twists and the cobra stretch.
  • Watch Your Posture Overthinking your posture isn't always helpful, but it is important to pay attention to any obviously bad posture that you may do as a result of your anxiety and stress. If you're sitting in a clearly bad position, try fixing it with better posture and see if that offers support. 
  • Pain Killers Over the counter pain killers are still a useful way to combat back pain. Even though your back pain is anxiety related, drugs like Tylenol are specifically designed for pain, and this pain can still respond well to pain killers. You may benefit from these treatments.
  • Exercise and Be Mobile Unless your back pain is so severe you cannot move, and if you've been advised to stay active by a doctor, try to be mobile. Walk around, exercise - do activities that keep your back strong. Don't over-exert or risk injury, but make sure you're not forgetting the value of physical fitness.
  • Massage Massage is a very useful tool for both back pain and stress. It is a great way to work out the pains in muscles, and when you're done you'll often find your back is less painful than it was previously.

These are all traditional ways to deal with back pain unrelated to anxiety, but they're still effective because once back pain starts, it needs to be stopped using traditional methods.

But of course, controlling your back pain is only step one. You will still need to learn ways to cope with anxiety so that you can stop your anxiety back pain from occurring again.


Anxiety causes muscle tension, inactivity, changes in posture, and other changes that can all lead to back pain. The pain is real, so over the counter painkillers, stretching, and similar treatments might be needed to eliminate the pain. In the long term, it becomes important to stop the anxiety. 

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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