How Stress Causes Physical Pain: The Brain–Body Connection Explained Simply

Dr. Amy Konvalin talks us through why it happens and what to do about it (besides just “manage stress”!):

It’s about signalling

Stress has a lot of effects when it comes to pain-signalling: it changes nervous system activity, increases cortisol, activates the fight-or-flight response, raises muscle tension, and can also excite inflammatory pathways, all of which can magnify existing pain even when there is a real biomechanical injury underneath.

• First, understand the pain cycle: irritation or injury sends signals to the brain, the brain interprets them as pain, and muscles tighten in response, which can worsen irritation, reduce movement, trap inflammatory chemicals, and create a repeating cycle where pain becomes increasingly widespread and sensitive.
• Next, what to do about it: because stress often causes shallow breathing (using your neck and shoulder muscles instead of your diaphragm), increasing tension, this means that deep diaphragmatic breathing can help by activating the vagus nerve, helping to shift the body out of fight-or-flight mode, improve regulation of inflammation, and reduce pain sensitivity.

In practical terms, lowering pain intensity even slightly can help people identify which activities truly aggravate symptoms, as shown in the example of a patient who only recognized prolonged desk sitting as a trigger after her overall pain level decreased through treatment, breathing work, and lifestyle adjustments.

One final note before we move on: pain is processed in the brain, so in that sense all pain is “in your head,” but that doesn’t mean it is imaginary or emotionally fabricated, because stress can biologically amplify real physical pain through nervous system and inflammatory mechanisms.

For more on all of this, enjoy:

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Take care!