Can Anxiety Cause Pain?
Everyone experiences pain; it’s our body’s built-in alarm system, designed to alert us to danger and protect us from harm. But what if pain could exist even when there’s nothing physically wrong? What if anxiety, a psychological state, could actually cause real, physical pain?
Welcome to the world of neuroplastic pain, a type of chronic pain that isn’t caused by injury or illness, but by changes in the brain and nervous system. In this post, we’ll explore how anxiety can trigger and sustain neuroplastic pain, how this process works in the brain, and most importantly, how it can be reversed.
What Is Neuroplastic Pain?
Neuroplastic pain, also called centralized pain or nociplastic pain, is pain that results from changes in the brain and nervous system rather than from structural damage in the body. It's a real, physical experience but it’s caused by the way the brain interprets signals, not by actual tissue injury.
This kind of pain is commonly found in conditions such as:
Fibromyalgia
Chronic back or neck pain
Tension headaches or migraines
Irritable bowel syndrome (IBS)
Temporomandibular joint dysfunction (TMJ)
Chronic pelvic pain
Nonspecific joint pain
While the causes of these conditions may appear “mysterious” or untraceable by medical scans or tests, neuroscience has shown that the brain can generate pain, even in the absence of physical damage, due to neural pathways formed over time.
Neuroplasticity: The Brain’s Power to Change
To understand neuroplastic pain, we first need to talk about neuroplasticity.
Neuroplasticity is the brain’s incredible ability to rewire itself based on experiences, emotions, thoughts, and behaviors. It’s what allows us to learn new things, develop habits, and recover from injuries.
However, this flexibility can work for us or against us. When it comes to chronic pain, neuroplasticity can lead to a situation where:
The brain learns pain.
What starts as a temporary pain from an injury or stressor can become hardwired into the brain. Over time, the pain persists even after the injury heals. The brain has created a “pain pathway” that fires repeatedly, even when there’s no longer a physical reason for it.
Anxiety and Pain: A Two-Way Street
Now let’s bring anxiety into the picture.
Anxiety isn’t just “in your head.” It’s a full-body experience involving:
Heightened nervous system arousal
Increased muscle tension
Shallow breathing
Racing thoughts
Stress hormone release (like cortisol and adrenaline)
Chronic anxiety keeps the body in a prolonged fight-or-flight state, a survival mode that primes your nervous system to detect threats. But when this system is overactive, it can start misinterpreting signals, including pain.
Here’s how anxiety contributes to neuroplastic pain:
1. Heightened Sensitization of the Nervous System
Anxiety causes central sensitization, a condition in which the nervous system becomes hypersensitive to pain signals. In this state:
Normal sensations (like pressure, movement, or heat) can feel painful.
Minor discomfort becomes magnified.
The “pain threshold” drops significantly.
This is similar to turning up the volume on a stereo; the sound (or in this case, pain) becomes more intense, even though the source hasn’t changed.
People with anxiety are more likely to interpret normal bodily sensations as dangerous or threatening; that interpretation alone can amplify pain signals.
2. Fear-Avoidance Cycle and Catastrophizing
When people experience pain, especially if it's chronic or unexplained, it’s natural to become afraid of it. But for people with anxiety, this fear can become overwhelming.
This often leads to:
Avoidance of movement (“If I bend over, I’ll injure my back again”)
Hypervigilance (“I’m always checking for signs that something is wrong”)
Catastrophic thinking (“This pain will never go away; something is seriously wrong”)
This is known as the fear-avoidance cycle, and it’s a major driver of neuroplastic pain. Every time you avoid something out of fear, the brain reinforces the belief that the situation is dangerous. Over time, this creates a learned association between movement, anxiety, and pain, even in the absence of injury.
3. Muscle Tension and Somatic Symptoms
Anxiety often manifests in the body as muscle tension, particularly in the neck, shoulders, back, or jaw. This prolonged tension can cause real pain over time, and because the muscles are constantly tight, the brain receives continuous feedback that something’s wrong.
This pain can be further amplified by somatic symptoms of anxiety like:
Stomach aches
Headaches
Chest tightness
Fatigue
Numbness or tingling
Even though these symptoms aren’t caused by injury or disease, they feel just as real, because they are.
4. Memory and Conditioned Pain Responses
The brain is a powerful prediction machine. Once it “learns” that a particular movement, environment, or situation causes pain, it may start triggering pain automatically, even when the original cause is gone.
This is similar to how someone might flinch at the sound of a dentist's drill, even if they aren’t being treated; the brain has associated that sound with pain.
In the same way, anxiety can cause the brain to anticipate pain, which can actually trigger pain, a kind of self-fulfilling prophecy.
5. Disrupted Brain-Pain Processing Centers
Brain imaging studies have shown that in people with chronic pain, areas of the brain responsible for processing emotion (like the amygdala) become more active, while areas that regulate pain perception (like the prefrontal cortex) may become less active.
Anxiety enhances this imbalance, making emotional centers stronger and logic centers weaker. As a result, the brain becomes less able to accurately interpret pain signals, and more likely to overreact to them.
Can Neuroplastic Pain Be Reversed?
Yes, and this is where hope comes in.
Because neuroplastic pain is learned, it can also be unlearned. The brain’s plasticity is what caused the pain to persist, but that same plasticity can be used to change how the brain interprets signals and ultimately reduce or eliminate pain.
This is not about “thinking away the pain”; it’s about retraining the brain to stop producing it unnecessarily.
Healing Neuroplastic Pain: Mind-Body Approaches That Work
Pain Reprocessing Therapy (PRT)
A breakthrough therapeutic approach that teaches the brain to reinterpret pain signals as safe, not dangerous. PRT combines somatic tracking (observing pain without fear) with cognitive techniques to reduce threat perception.Cognitive Behavioral Therapy (CBT)
CBT helps reframe fear-based thoughts and break the fear-avoidance cycle. It’s effective for both anxiety and chronic pain.Mindfulness and Meditation
Practicing mindfulness calms the nervous system, increases interoceptive awareness (noticing bodily sensations without judgment), and helps regulate emotional responses to pain.Graded Exposure to Movement
Slowly reintroducing feared or avoided activities (e.g., walking, bending, exercising) helps show the brain that movement is not dangerous, breaking the conditioned pain response.Education
Understanding the neuroscience behind pain is therapeutic in itself. When people realize their pain is not a sign of damage, but a product of a sensitized nervous system, fear decreases, and so does the pain.
Real Stories, Real Hope
Many people suffering from neuroplastic pain have found lasting relief after addressing the underlying anxiety and fear behind their symptoms.
Books like The Way Out by Alan Gordon have helped thousands understand the mind-body connection and start the healing process.
The key takeaway: Just because pain isn’t caused by injury doesn’t mean it isn’t real. It simply means the source is neural, not structural, and that means it can change.
Final Thoughts: Rewiring Pain Through Awareness and Compassion
Anxiety and pain often go hand in hand, not just emotionally, but neurologically. The brain, in its effort to protect us, sometimes becomes overprotective. It begins to sound the alarm even when there’s no danger, producing pain as a warning signal rather than a reflection of damage.
The good news is that this process is reversible. With the right tools, education, and support, people can learn to calm their nervous system, retrain their brain, and live free from the grip of neuroplastic pain.
If you’re living with chronic pain and haven’t found answers through medical tests or procedures, it may be time to look at the brain, not the body, for the solution.
Resources and Further Reading:
The Way Out by Alan Gordon, LCSW
Curable App – Mind-Body Pain Relief
Disclaimer: This blog post is for informational purposes only and not a substitute for professional medical advice. Always consult with a healthcare provider before starting or stopping any treatment.