Tension can be the overlooked cause of headaches, back pain, neck aches and more.


Mental stress has always had its physical component. In fact, that's what the stress response is: the visceral priming of the body to either fight or run away from a perceived danger. Less well recognized is that even chronic, unpleasant stress, the kind that's so constant you consider it normal, can cause aches and pains that you might not attribute to emotions. By some estimates, half of the patients doctors see for various common body aches, such as jaw pain, are actually expressing psychological distress through physical pain.

The source of stress-related pain lies in the brain, which, when you feel under the gun, triggers the release of cortisol, adrenaline and other hormones that prepare the body for action by, for example, increasing heart rate, blood pressure and respiration. Less noticeably, these hormones also make muscles tense up, which can cause aches and irritate nerves.

Here's a guide to the areas stress hits most often, and simple steps you can take to relieve the pain and symptoms of stress.

Jaw Pain

Pain on the side of the face that can radiate to the head or neck may be indicative of the jaw malady known as temporomandibular joint disorder (TMJ). But in many cases, the problem isn't the joint connecting the jaw to the skull, but muscular tension caused by clenching your teeth while under stress. Before you schedule that operation, ease tension in muscles that operate the jaw:

  • Open your jaw as wide as you can, hold for a few moments, then gradually let it relax. You may feel more pain initially, but that's a function of muscle tightness; the discomfort should dissipate as you work the muscles.
  • Try to make a habit of holding your jaw open slightly so that your upper and lower teeth don't touch. Resting your tongue against the roof of your mouth while you do this can help keep teeth separated so you won't clench or grind them.
  • Stress can cause you to clench or grind your teeth at night. Speak to your doctor; she may recommend a mouth guard to both minimize damage to your teeth and cushion pressure from the jaw, which may help relieve jaw pain.

Lower Back Pain

Low back pain can be caused by many different factors, such as poor posture or pressure on the spine from long hours of sitting. But a classic Swedish study of low back pain in the workplace more than a decade ago showed that women who reported signs of stress such as dissatisfaction, worry and fatigue were more likely to experience low back pain than those who had physical stressors like doing a lot of lifting.

More recently, researchers at Ohio State University found that when volunteers felt stressed (from a snippy lab supervisor criticizing them as they tried lifting an object), they used their back muscles in ways that made them more susceptible to injury. For back pain relief, try these tips:

  • Stand with your heels and shoulders touching a wall. Tilt your pelvis so that the small of your back presses against the wall, relieving back muscles. Hold for 15-30 seconds. Do this exercise regularly to reduce your risk of getting back pain or to relieve existing pain.
  • Strengthen your abdominal muscles, which support the spine, by doing crunches three times per week. Lie flat on your back on an exercise mat with hands cupped behind your ears. Feet should be together and flat on the floor, with knees bent at about a 45-degree angle. Curl your upper torso up, bringing ribs in toward hips until your shoulder blades clear the floor. Do one set of 15-25 crunches; gradually build to three sets. Also, increase endurance of the muscles along the spine, the spinal erectors, by doing alternate leg and arm raises from an all-fours position, holding each position for eight counts. Initially, do one set of 10 repetitions, building up to three sets.

Neck and Shoulder Pain

Neck pain may start with bad habits like squeezing the phone between your shoulder and your ear, but tension in neck muscles worsens the problem, often causing pain to radiate. A recent study in Finland found that in addition to physical factors like working with a hand raised above shoulder level, mental stress is strongly linked to the likelihood of experiencing radiating neck pain.

In most cases, alleviating neck pain will also benefit shoulder pain as well. Here is what you can do:

  • Give your neck muscles an all-around stretch one step at a time. First, while sitting erect in a chair, lower your chin to your chest, letting the weight of your head gently stretch tense muscles at the back of the neck. Hold the stretch for 15 seconds.
  • Next, gently let your head drop toward one shoulder. Hold for 15 seconds and repeat on the other side.
  • Use progressive muscle relaxation, in which you mentally focus on muscles and consciously allow them to relax. You need to isolate the muscles first by actually tensing them more: Rest your elbows on your desk and press your face against your hands, then release, which will relax the muscles in your neck. Mentally note the neck muscles you're using and, over the course of about 15 seconds, slowly release their tension. Keep focusing on your neck muscles even after you lift your face from your hands, imagining the muscles deeply relaxing.

Tension Headaches

Tension headaches, one of many signs of stress, are sometimes called hatband headaches because pain occurs all around the head, although it's most intense at the temples and back of the skull. The tight areas causing the ache, however, are often concentrated in the face and neck, referring pain through muscle fibers and nerves.

Some research suggests that people with tension headaches are especially prone to see (or remember) everyday events as stressful, though studies are contradictory. A greater concern is that those who have headaches frequently are at higher risk of depression and anxiety. If you have more than several headaches a month, consult a doctor to see what else may be going on.

In many cases, however, tension headaches are short-lived and infrequent. To deal with yours:

  • Go easy on over-the-counter pain relievers: Some brands contain caffeine, which, if taken too frequently, cause caffeine-withdrawal, "rebound" headaches that make the problem worse. Also consider cutting back on coffee, but don't go cold turkey. Try drinking just one cup a day, every day to avoid caffeine-withdrawal symptoms.
  • Use self massage techniques that address the muscles in the face and neck that often refer pain to the head. Start by gently pressing your fingers on both sides of your face around the hinge to your jaw, rubbing the area in a circular motion, then kneading the skin with your fingers. Next, move hands to the area just behind the jaw and below the ears, massaging gently as you slowly slide hands down your neck to the base of the shoulders.