Muscle pain and anxiety

Anxiety and stress can cause ailments of various kinds, including muscle pain, especially in women and young people.

Almost 9 out of 10 Italians suffer from disorders related to psychophysical stress: it emerges from a recent research on the subject promoted by Assosalute (National Association of Self-medication Drugs), according to which 85 percent of the population interviewed – especially women and young people – has suffered from at least one disorder in the last six months, while 45 percent claim to have had three or more.

Among the most complained symptoms, headaches and dizziness (46.2 percent), chronic fatigue (45.9 percent) and stomach problems (26.9 percent), but also muscle tension and pain (25.5 percent).

Stress is a signal that the body sends us to react to a dangerous situation, even when it concerns the quality of life.

Piero Barbanti, director of the Unit for the treatment and research on headaches and pain, IRCCS San Raffaele in Rome, explains: “It is not the event itself that determines a stressful reaction, but the way we deal with it. However, there are situations that generate stress more easily: specific events, such as a bereavement or separation, work worries, an exam to pass, moving, but also having very intense rhythms of life. Some studies show that just living in big cities, with the pressure that comes with it, increases the risk of suffering from mental disorders and the likelihood of having a panic attack.

If stress becomes chronic

However, when stress and irritability become chronic, the body produces large amounts of cortisol and the nervous system is in a condition of constant inflammation that also puts pressure on the immune system. And it is precisely this inflammation from “chronic emotional hypertension” the cause of all those illnesses or real pathologies commonly associated with stress: from headache to insomnia, from stomach pain to muscle tension (and therefore to widespread pain, from neck to back to legs), from nausea to dizziness, from tachycardia to the syndrome of irritable bowel, from dermatitis on hands and feet to pangs in the heart.

«Man is still an “animal”, from a certain point of view: anxiety derives from the fear caused by the need to react to external events», confirms Stefano Negrini, associate professor of Rehabilitation Medicine at the University of Brescia and scientific director of the IRCCS of Rovato and of the Don Gnocchi Foundation onlus of Milan. “The preparation for this response implies a contraction of the muscles so that it is ready to shoot, to escape. When the movement does not take place, this contraction generates a form of asphyxia at the level of the muscles that are not well oxygenated, because the blood arrives only through contraction and relaxation of the muscle itself, with a “pump” mechanism. The contracture, that is, the contraction without release, generates the toxins that then give rise to pain. Anxiety and stress are a facilitator of pain, which is obviously greater in people who are already predisposed to other problems, and a condition of anxiety accentuates them.

A further effect of anxiety should be emphasized: “It predisposes, from a psychological point of view, to perceive pain with greater intensity, regardless of the causes”. And vice versa: it happens to everyone to wake up before leaving for a day at the beach with muscle stiffness – a pain in a shoulder, a lumbar back pain – but then not to feel it anymore or almost enjoying relaxation on the beach. “In technical terms, we speak of a ‘pain gate’,” explains Professor Negrini. “A sort of obligatory passage through which pain passes, and which can be more or less open depending on the psychological state of the person, with consequent alteration of his perception. The evil we feel, in short, is the combined effect of a physical and psychological mechanism». As proof, the fact that fibromyalgia, that is chronic pain of neuropathic origin, in some cases is also treated with antidepressant drugs.

In everyday life we often have postures forced by work: long hours at the desk with our gaze fixed on a monitor or, on the contrary, standing in a static position in a store or controlling a machine in a production plant. Anxious states can favor incorrect attitudes: “Posture is closely linked to our psychological attitude,” continues Stefano Negrini. «So much so that if we talk about a “closed person” we imagine someone uncomfortable, with closed shoulders, victim of depression, “hunched under the weight of fatigue”, while the swaggering, determined and self-confident individual “faces life head-on” and therefore necessarily with open shoulders. Anxiety enters all this, causes closed and hunched postures that in the long run can cause muscle contractures and therefore pain“.

Physical activity, relaxation and proper nutrition are anti-stress allies

Are there areas where anxiety is more likely to cause pain? “The back, the cervical spine and the lumbar spine. But, once the diagnosis is made, there is no solution to the problem that is valid for everyone. Postures determined by personality and psychological attitudes have roots too deep to be modified with a universal recipe. In general, it is necessary to find personalized ways to reduce anxiety, from the practice of a sport – the important thing is to find an activity that is feasible according to one’s characteristics and that one likes, so as not to abandon it immediately – or a simple continuous physical activity (walking, cycling, swimming, dancing), from a balanced diet to cognitive-behavioral psychotherapy and relaxation techniques, to work, for example, on self-esteem or shyness».

Even for oriental medicine, muscle pain can have an origin in emotions. “In yoga, the first recognizable symptom of a person’s state of anxiety and worry is breathing,” explains Daniele Campestrin, Ayurvedic operator and yoga teacher at the La Reserve Wellness Center in Caramanico Terme (Pescara). “It is short, fast and tends to contract especially the upper part of the shoulders, even with involuntary moments of apnea. By focusing on our breathing we can first become aware of the anxious state and modify it with deep breaths. By relaxing the jaw, neck, shoulders we can immediately recover calm and counteract difficulty concentrating. The regular practice of yoga, in which movements are always coordinated with the breath, is very useful to learn to “let go” of what creates tension. And so can Ayurvedic massages that work on the back, diaphragm and abdomen.”

Some practical tips for everyday life

Improving the situation is however possible even regardlessof the mind and, as suggested by Salvatore Minnella, surgeon specialized in physiatry of the Italian Scientific Institute of Spine Column. “You don’t have to spend too many hours in front of the computer, but every hour get up for two to three minutes and take a few steps around the desk, perhaps taking advantage of phone calls. When sitting, disjointed positions should be avoided: the handset on one shoulder and the eyes turned to the opposite side to look at the monitor, for example. The video must be frontal, with the upper edge at eye level and the keyboard at a distance from the edge of the table that allows us to rest the forearm on the top. The chair must have a comfortable and slightly inclined backrest».

If there is a strong tension prolonged over time that affects posture, to avoid overloads and collapses (that back pain that then prevents us from enjoying the weekend) as soon as you feel tired, those who sit for a long time, get up and flex the column; vice versa, those who stand for a long time, sit down. It is a sort of physical “reset” – just a few minutes – that helps to ease tension even on a mental level.

10 tips from Assosalute to deal with stress-related disorders

1. Walks in the fresh air: clears thoughts and promotes the circulation of endorphins which reduces stress hormones.

2. Avoid using smartphones or PCs in the evening. It is important to turn off phones and computers at least an hour before bedtime.

3. Learn how to organize your days better. A very common cause of stress is “lack of time”: good management of your agenda can help you feel more relaxed and in control of yourself.

4. Take care of your nutrition. There are foods that can reduce the action of the main stress hormone, cortisol: turkey, tuna, salmon, spinach, dark chocolate.

5. Make an effort to give the right importance to things. Scaling down problems helps you realize how many things you really aren’t worth worrying about.

6. Keep a functional attitude. Paying attention to your thoughts and asking yourself questions can be useful to ward off anxieties and problems. An internal reflection can often help us to better understand an external situation.

7. Help yourself with meditation. You can try mindfulness, the most scientifically studied form of meditation. Done daily it can give excellent results from a neurochemical point of view.

8. Laugh as much as you can. In fact, it is proven that laughter is good for health because it increases the amount of oxygen you breathe, stimulates the heart, lungs and muscles and increases the endorphin that releases the brain.

9. Listen to music. It will help you take a break from the many commitments of the day and infuse your brain with mood neurotransmitters, such as dopamine.

10. However, if stress turns into real physical ailments, self-medication drugs can be useful, including light sedatives based on natural remedies such as valerian or passionflower that improve the quality of sleep.