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©2006-2011 Deborah Wiig
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Anxiety Disorders and Chronic Pain
They often occur together

Muscle tension, body soreness, headaches. For people with anxiety disorders, pain like this may be all too familiar. Pain can be a common symptom — and sometimes a good indicator — of an anxiety disorder, particularly generalized anxiety disorder (GAD). Some people will also suffer a chronic pain disease such as arthritis or fibromyalgia. But people can manage anxiety disorders and chronic pain to lead full and productive lives.

How are these co-occurring conditions treated?
Many treatments for anxiety disorders may also improve chronic pain symptoms. Usually a comprehensive plan with a number of treatment components is necessary, and may include these treatment options:

• Cognitive-Behavior Therapy (CBT) helps patients identify, challenge, and change unwanted and unproductive thoughts and feelings, as well as modify and gain control over unwanted behavior.
  
• Medication is often used in conjunction with therapy and other treatment techniques as a short- or long-term treatment option. Some people with an anxiety disorder and chronic pain may be able to find one medication that helps alleviate the symptoms of both conditions. Others may take one medication for anxiety and another for pain management.
  
• Relaxation techniques may help individuals develop the ability to cope more effectively with the stresses that contribute to anxiety and pain. Common techniques include breathing retraining, progressive muscle relaxation, and exercise.
  
• Complementary and alternative methods, such as yoga, acupuncture, therapeutic massage, and biofeedback (controlling how the body reacts to stress to reduce its effects), can relieve the symptoms of both anxiety disorders and chronic pain.

What lifestyle changes can help?
Many lifestyle changes that improve the symptoms of an anxiety disorder also help the symptoms of chronic pain.

• Good nutrition can influence both anxiety and chronic pain symptoms. People with anxiety should limit or avoid caffeine and alcohol, which can trigger panic attacks and worsen anxiety symptoms. According to the National Fibromyalgia Association, certain foods aggravate some musculoskeletal conditions; including dairy products, gluten (found in wheat, oats, barley, and rye), corn, sugar, along with potatoes, tomatoes, eggplant, peppers, and tobacco. Talk to your doctor.
  
• Regular exercise strengthens muscles, reduces stiffness, improves flexibility, and boosts mood and self-esteem. All individuals, particularly those with chronic pain, should check with their doctors before beginning an exercise regimen.
  
• Sleep management — Getting a good night’s sleep is key for anxiety disorders and chronic pain conditions. Consistent sleep and wake times, a good sleep environment (comfortable room temperature, no TV or other distractions), and avoiding caffeine late in the day can help promote restful sleep.

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Excerpted with permission from Anxiety and Pain, Anxiety Disorders Association of America.

Page updated July 1, 2009