Neuropathic pain on its own is stressful enough. It can be difficult to diagnose and treat, and chronic pain conditions can lead to further mental health challenges. But can anxiety cause nerve pain? Here’s what we know, plus 14 treatment options for both.
Can Anxiety Cause Nerve Pain?
Anxiety is the most prevalent mental health challenge in the U.S., affecting just over 18% of adults over 18 in the U.S. The list of disorders that fall under the category of “anxiety” includes:
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder
- Post-traumatic stress disorder (PTSD)
While anxiety cannot lead to nerve damage that causes pain, it can actually intensify nerve pain caused by injury or accidental nerve damage. Let’s look deeper at how anxiety pain symptoms work.
What are the major types of nerve pain?
It’s helpful to have a clear understanding of what nerve pain is before diving in. All nerves are signaling pathways to the brain. They tell us if something tastes good or bad, that we need to pick up our feet to walk up the stairs, and that we’ve stubbed our toe on the foot of the bed.
Nerve pain directly involves a nerve. Yes, when you whack your elbow it hurts, but it’s unlikely to damage any nerves, and the pain subsides quickly. With nerve pain, the signaling pathway itself is damaged.
Think of it like a road with a pothole. Technically the road is functional, but the pothole makes travel difficult and slow, and sometimes the tires hit the pothole so hard that the car’s occupants are jostled. Eventually the pothole widens and completely blocks the road.
Nerve pain is often just as bumpy as driving over potholes, and it can eventually consume all other sensation. When nerves are damaged, that same bumped elbow can send you to your knees, writhing in pain.
Some of the most most common types of nerve pain include:
- Complex regional pain syndrome: Chronic pain that occurs after an accident or serious injury
- Peripheral neuropathy: Pain that arises often as a consequence of fluctuating blood sugar seen in people with diabetes
- Postherpetic neuralgia: Painful rash caused by the virus responsible for chickenpox
- Trigeminal neuralgia: Facial and head pain caused by inflammation in or around the trigeminal nerve
In all cases, nerve pain arises due to some kind of damage, inflammation, or injury to the nerves — more than just a temporary bruise or injury.
Symptoms of nerve pain of all kinds may include:
- Stabbing or sharp pain
- Dull, constant ache
- Temperature changes
- Excessive sweating
Pain can come in waves, be constant, or change depending on the amount of movement. It can be felt directly in the area of injury or damage, but it might also focus on the periphery of the body: the hands, arms, legs, and feet.
One of the most puzzling aspects of nerve pain, though, is its relationship to anxiety.
Why Does Anxiety Cause Nerve Pain?
Can anxiety cause nerve pain? That’s the million-dollar question, and the answer is as complex as pain conditions themselves. It’s clear from pain research that the perception of pain is influenced by mental health — and the opposite is also true.
We know depression is a moderator of pain severity, and chronic pain increases the chances of developing depression threefold. When it comes to anxiety and peripheral neuropathy (as well as other types of nerve pain), there are also a variety of ways each influences the other.
People with anxiety may have overactive nerves
Among other things, the sympathetic nervous system controls changes to blood pressure, heart rate, sweating, and pupil dilation and contraction. Some researchers have found that people with anxiety disorders have a very active sympathetic response. They suffer from dramatic increases in their body at very minor stimuli. One study in particular found that people with anxiety had a greater response to both physical and mental stress in the form of pain.
The study also found that the frequency of the pain did not increase, but the feelings when pain occurred were much more intense than in people without anxiety. This can set off a cycle of increased anxiety as nerve pain increases — that then leads to more anxiety.
Anxiety symptoms mirror neuropathic symptoms
A common symptom of anxiety — dysesthesia — is also a symptom of neuropathy. This term covers a variety of sensations that include burning, tingling, numbness, skin crawling, and even pain. Crucially, none of these symptoms are caused by an injury where the sensation occurs. It’s widely recognized as caused by nerve trauma far away from the sensation.
What’s interesting is that people with anxiety and nerve pain may experience these symptoms as a result of either condition, then mistake them as caused by the other condition. So anxiety, essentially, can read as nerve pain — and vice versa.
Anxiety makes regulating pain perception challenging
It’s well-documented that the psychological response to pain helps either decrease or increase the actual sensation of pain.
In people who suffer from anxiety, their pain perception is on high alert, leading to a catastrophizing view of pain. Known as “distorted cognition,” this means that people with anxiety struggle to right-size their perception of how bad their pain really is.
Again, this doesn’t mean it’s all “in their head.” This issue directly influences a person’s actual experience of pain, and can take dedicated treatment to manage.
What’s The Relationship With Stress?
Stress (and the stress response) isn’t necessarily classified as an anxiety disorder, but it’s safe to say that many types of anxiety are triggered by stress. Stress and nerve pain can occur at the same time, and, as with anxiety, each can intensify the other.
Consider a stress response in the body:
- Rapid heart rate
- Shallow breathing
- Increased perspiration
- Increased blood pressure
- Racing thoughts
As blood rushes to the vital organs at the center of the body in reaction stress, the hands and feet may feel numb or start to tingle. These are all similar feelings that arise when pain is present in the body, too.
When we stub a toe, these feelings of stress and pain are transient and fade. But when pain persists, the body naturally releases stress hormones. These stress hormones allowed us to leap out of the way of an oncoming tiger, but when they continue to flood our body, damage occurs. In a vicious cycle, stress damages the body, causing pain, and pain that is already present increases. Some research has shown that chronic stress can actually damage the peripheral nerves.
While stress on its own may not be enough to cause nerve pain, it can certainly intensify pain that is already there and make healing of both conditions more challenging.
How To Stop Anxiety Nerve Pain
Anxiety nerve pain management is most successful when the symptoms of both conditions are treated at the same time. Some treatment options focus on one or the other, while others are beneficial for both.
But, when you relieve anxiety, aches and pains may also be reduced as a side effect.
General Anxiety Management
Anxiety is a full-body response that requires both physical and mental treatment. There are a few options that can help ease and reduce symptoms and even eliminate anxiety over time.
One of the primary ways to manage anxiety is through therapy. Although there are a few studies that indicate biological markers responsible for anxiety, much of this disorder is in response to trauma (or is a learned response). If the latter is true, therapy can help unpack the roots of anxiety to address its primary cause.
The use of herbal medicine to treat a variety of mental and physical ailments has a long history that is only in the past four decades being explored in modern research. A systematic review in 2018 found that the following herbs were useful in easing the symptoms of anxiety:
- Black cohosh
A study in 2013 found that kava was effective at reducing symptoms of anxiety, but another study in 2020 indicated that the effects were moderate. Both studies were small, and research summaries did note that side effects of this type of treatment (and all herbs) were minimal. For patients taking additional medications and concerned about interactions, herbs may be a good route to travel. Always talk to your doctor when adding new supplements to your routine, though.
Anxiety medications won’t erase the root cause of anxiety, but they allow you to ease symptoms while you explore other treatment options. Some of the primary medications used for anxiety include:
These benzodiazepines provide relief from symptoms in the middle of anxiety episodes, but because of their addictive nature are suboptimal for long-term use. For long-term management, many doctors prescribe different medications, including:
Anxiety Pain Symptom Management
When pain is exacerbated by anxiety, specific treatments for that pain condition can help. They range from conservative treatments to more invasive options that focus on the pain condition itself.
1. Physical therapy
Physical therapy is often the first stop after an acute pain episode, but it has applications for chronic pain, too.
A physical therapist designs specific exercises to strengthen and condition the body to help it recover and move in a new pain-free way. You might start with a session or two a week, then graduate to exercises you can do at home.
For nerve pain that is related to structural challenges in the spine, chiropractic care can be a good option. Using a combination of manual adjustments and special tools, chiropractors manipulate and move the bones and muscles to realign the spine.
Although opioids are not recommended for chronic pain, there are other medications that may help. These include specific classes of antidepressants. It is unclear how these medications relieve chronic pain, but taking them can provide both physical and mental relief from pain for many people.
Injections can be used as both a diagnostic tool and a treatment. Depending on the area of pain, the injection targets the affected nerves to help provide relief. Many injections relieve pain for long periods of time and can be useful as a person moves through other rehabilitative exercises.
Radiofrequency ablation uses an electrical current to block pain signals from traveling along neural pathways. These are used in conjunction with blocks that identify the nerve sending pain signals.
If treating pain becomes more challenging, you may find relief with peripheral nerve stimulation. With peripheral nerve stimulation devices, electrodes are placed along the nerves that delivers a direct electrical current. This disrupts nerve signaling from reaching the brain.
When other minimally-invasive approaches are not helpful, your doctor may recommend a surgical solution. This can be life-changing for people who have struggled with lower back pain and other causes of nerve pain for years.
Complementary Care For Anxiety And Nerve Pain
For a more holistic approach, complementary care is important. It should be used in combination with other treatments mentioned above.
Because anxious chronic pain patients have difficulty with their perception of pain, calming the mind through meditation is a useful tool. Mindfulness meditation, in particular, allows patients to reduce catastrophic feelings when confronted with pain and anxiety.
Biofeedback is the practical application of meditation. After hooking up to sensors that monitor vital signs such as temperature, respiration, and perspiration, patients are trained to recognize the signs of anxiety and pain and to control their response.
Acupuncture is based on 3,000+ years of practical application. This traditional Chinese medical practice uses hair-thin needles placed at strategic points in the body. Practitioners believe that energy or qi (pronounced chee) gets stuck in these areas, and the acupuncture needles release that energy. Modern research has found that acupuncture is helpful to relieve anxiety and ease pain.
Adding exercise and improving nutrition are good for general overall health, but they also can reduce symptoms of both pain and anxiety.
Get Help For Severe Cases
If you’re suffering from chronic pain, we can help at Arizona Pain. We offer a variety of nerve pain treatments to help manage your pain.
Suffering from severe pain, mental health, and substance abuse issues? Phoenix residents on Mercy Care insurance can also turn to Arizona Pain’s comprehensive ten-week program for treatment of chronic pain, mental health disorders, and medication assisted treatment. Our Center of Excellence program is a life-changing option that provides the immediate support and care you need. We are with you every step of the way, offering follow-up check-ins and comprehensive treatments.
If you have a different health care provider, or don’t require substance abuse support, Arizona Pain offers a wide variety of holistic treatments to address both the physical and mental aspects of chronic pain. Get in touch today to see how we can help you get your life back.