Muscle pain from stress: how tension settles in your muscles, why pain can spread and when to see your GP

In this article you will read what stress-related muscle pain is, how stress makes your muscles tense up, why pain can suddenly seem to be everywhere and what you can do about it yourself. That matters, because the pain is real, and when you know the cause, you can see more clearly when the pain will probably pass and when it is time to see your GP. Thuisarts lists headache, neck pain and back pain among the complaints that stress can cause, and explains it simply: under stress, your blood pressure goes up and your muscles tense up.⁠⁷ The BioProfile recovery scan gives you an indication of where you stand today when it comes to recovery. This is not a diagnosis. It is insight, to see where you stand today and to help you make better choices in your diet and lifestyle. What this scan does not do is point to a cause. Only a doctor can assess that.

What muscle pain from stress is and how it feels

Stress-related muscle pain is pain in muscles that tense up when you are under pressure. According to Thuisarts, this pain can be in your neck, your back or your head.⁠⁷ Thuisarts also names tension as a possible cause of neck pain, and writes that some people mainly have neck pain during periods of stress.⁠⁶

Put simply: if your neck, shoulders or back hurt more in busy, tense weeks, that is a pattern Thuisarts recognises.

How stress makes your muscles tense up

At Universiteit Maastricht, researchers measured muscle activity in the trapezius, the muscle between your neck and shoulder, in 70 adults aged 18 to 65. For 64 of them, the data could be analysed. During three minutes of waiting for one unpredictable electric shock, the muscle was clearly more active on both sides than at rest, and after the shock it relaxed again. People who said they felt more stress while waiting showed a stronger rise, and there was no difference between the left side and the right side.⁠¹

What this means for you: just waiting for something unpleasant is enough to make your shoulder muscles work harder, and the muscles relax again as soon as the moment has passed. The study measured minutes in a laboratory. It does not show what months of stress do.

Why it can suddenly hurt everywhere

A British study followed 3,171 adults aged 25 to 65 without pain across the whole body for 15 months. By the end, 324 of them, about one in ten, had developed new pain across the whole body. Three things predicted the pain independently of each other: reporting many other physical complaints, being strongly focused on being ill, and sleep problems. In people with all three, the pain was far more likely than in people who scored low on all three.⁠⁴

Put simply: in this study, pain across the whole body was most likely in the people who slept badly or already had many other physical complaints.

In the Dutch NESDA study of 2,981 people, almost everyone reported some pain, and most of it was in the muscles and joints. People with depression or an anxiety disorder had clearly more severe long-term pain than people with neither, and those who had both had the most pain. Even after the depression or anxiety had passed, pain still got in the way of daily life more than in the control group.⁠⁵

So mood and pain go hand in hand. If your pain comes with a low mood, constant worrying or panic attacks, talk to your GP about it.⁠⁷

What research can and cannot yet tell us

A systematic literature review looked only at studies that first measured stress and then followed people over time. The review found just seven such studies, from six groups of people, and only limited evidence that stress and difficult life events help cause arthritis and spinal pain. The authors called the evidence weak and asked for better research.⁠²

A larger review of reviews brought together 13 literature reviews covering 185 studies and 489,644 people, and found a link between 34 factors and pain that becomes long-lasting. The strongest evidence was for five: smoking, avoiding movement out of fear of the pain, less support from the people around you, a lower social and economic position, and a lot of pain at the start. For stress, the evidence was not very certain.⁠³

What this means: stress tenses your muscles in the moment itself,⁠¹ but whether stress on its own turns into lasting pain has not yet been proven.⁠² There is stronger evidence for what goes on around it.⁠³

What can help with muscle pain from stress

Relieving muscle pain from stress starts with the stress itself. When stress has lasted a long time, Thuisarts says it is important to do something about the cause.⁠⁸ In the laboratory, the muscles relaxed as soon as the stressful moment was over, although that was a matter of minutes, not months.⁠¹

Give it time. Neck pain usually has no clear cause and passes within a few weeks; in about one in seven people the pain lasts longer than six months.⁠⁶ Look at your sleep, because sleep problems were one of the three signals for pain that spreads across the body.⁠⁴ And bear in mind that avoiding movement out of fear of the pain was one of the factors linked to pain that persists.⁠³

When to see your GP

Make an appointment if you cannot bring your stress down and want help, if you are feeling worse, if new complaints appear such as anxiety or panic attacks, or if daily life is clearly getting harder.⁠⁷ When stress has lasted a long time, Thuisarts recommends an appointment with your GP or practice nurse.⁠⁸

With neck pain, contact your GP if the pain gets worse instead of better, has not eased after two to four weeks, or if your neck still moves too little after four weeks. The same applies if the pain spreads to your arm, or if the strength or feeling in your arm decreases. Call your GP straight away if you have a suddenly stiff neck, where your chin cannot touch your chest, together with fever, confusion, a severe headache, repeated vomiting or purple spots on the skin, because this can be a sign of meningitis.⁠⁶

What a recovery scan can and cannot show

A questionnaire records how you feel. A questionnaire cannot tell whether the cause of a painful neck is tension or something else. The scan is not a diagnosis. Finding the cause is work for a doctor. What you do get is a starting point: repeat the scan later and you have two numbers instead of a feeling.

In summary

Stress makes your muscles tense, often in your neck, back or head, and in the laboratory the muscles relaxed as soon as the stress was over.⁠⁷ ⁠¹ Pain all over the body went together with poor sleep and many other physical complaints, and pain is more severe and gets in the way of daily life more with depression and anxiety.⁠⁴ ⁠⁵ Whether stress alone leads to lasting pain has not yet been proven.⁠² ⁠³ Doing something about the cause of the stress comes first, most neck pain goes away within weeks, and Thuisarts lists clear signs that mean you should see your GP.⁠⁸ ⁠⁶