How Stress Leads to Neck and Shoulder Pains

Several research works across different fields have connected stress’s physiological over the past two decades, biochemical, molecular, and psychological mechanisms with musculoskeletal disorders (MSDs). The pathophysiology of muscular pains has been linked to physical and psychological causes. Pains in the neck and shoulders can result from strain, trauma, necrosis, nerve compression, injuries, disease, and other physical causes. However, they can also be caused by the stress we often experience

What Is Stress?

According to Richard S. Lazarus, stress is a condition or feeling experienced when a person is faced with demands that exceed the personal, emotional, and social resources that he can mobilize at that time. It is not necessarily about the situation you face but how you respond or react to it. 

Stress is not bad on its own. It is the body’s response to a challenge or danger. It is the mechanism that helps the body to survive the emotional and physical strain of everyday life and emergencies.

Any trigger that can cause the body to respond to stress is called a stressor. An intrinsic stressor originates from inside the subject: hunger, fatigue, pregnancy, anxiety, anger, or fear. On the other hand, extrinsic factors include noise, alarms, work pressure, assignments, examinations, danger, emergencies, or test results. 

Stress Response in Survival

Acute stress response may have played a significant role in human survival at a time when human beings had to deal with many physical threats; however, as we settled for a more sedentary lifestyle in the cities, our stressors are no longer be physical threats to survival, but interpersonal, psychological, and emotional. Also, our bodies are still responding to these modern threats the same way they would have reacted to physical stress.

The stress response is both physical and psychological. Physically, the body is in a state of sustained physical alertness, and psychologically, the mind is in a sharp and overworking condition.

These are the results of stress hormones such as cortisol from the adrenal medulla, adrenaline from the adrenal medulla, and vasopressin, aldosterone, and dopamine. 

Stress Response Coordination

Centrally, the stress response is coordinated by the sympathetic-Adreno-medullar (SAM) axis and the brain’s Hypothalamus-Pituitary-Adrenal (HPA) axis. Peripherally, stress is coordinated by the branch of the peripheral nervous system known as the autonomic nervous system, especially by the sympathetic branch that pushes the body into overdrive. 

Stress response doesn’t only help us deal with everyday stress and emergencies; it helps to drive our productivity, innovation, performance, and memory. Therefore, the primary motivation must be to work hard and perform well in the arts, physical activities, academics, and everything that involves effort, resilience, and mastery.

The Chronic Problem

However, the problem with the stress response is when it becomes chronic. Chronic physical stress can result from manual labor, especially those involving standing or sitting for long hours, lifting objects, or other forms of repetitive motion at the workplace.

Chronic psychological or emotional stress often develops from dealing with financial challenges, bad debts, toxic relationships, demanding bosses, or academic difficulties.

On the molecular level, physical and emotional stress seems to accelerate the aging process. In addition, chronic stress leads to accelerated biological aging with the evidence of shorter telomere length, systemic inflammation, and moderate to severe oxidative stress

Why Neck and Shoulder Pains?

Our neck and shoulders are some of the most common body parts that easily bear the burden of stress-induced pain. It is a result of constant tension of the neck and shoulders muscles. These parts of the body played significant roles in surviving and escaping dangers and threats in our ancestors; they still tense up when we are faced with psychological or physical threats.

Stress can lead to pain in the shoulders and the neck due to a combination of the following: 

●    Clenching and tightening of muscles, especially in the neck, shoulders, and jaw. Like every other stress coping mechanism, these clenching and tightening are spontaneous and are sustained by the autonomic nervous system as they are involuntary.

● Enlargement of the blood vessels to the muscles of the neck and shoulders. This enlargement often leads to a compression of the nerves and pain in the muscles around the region.

●    Tension in the trapezius and the sternomastoid; are the large bands of muscles that spread from the neck and shoulders down the spinal cord. They carry the 10 pounds weight of the head and become strained when we lean forward at our work desks.

● Increased perception of pain (hyperalgesia) further leads to more stress by a form of positive feedback loop. It is one of the most critical aspects of pain during stress. 

Stress-Induced Analgesia and Hyperalgesia

Stress leads to pain and modulates the perception of pain in a bidirectional manner, a condition called stress-induced analgesia or stress-induced hyperalgesia. Analgesia (reduction in pain perception) results from mild to moderate acute stress. In contrast, hyperalgesia (increased perception of pain) results from severe or chronic stress that has caused damage to nerves and chemical changes to the nerve pathways. 

Treatment for Stress-Induced Neck and Shoulder Pains

The goal of any form of therapy for stress-induced neck and shoulder pains is to pay closer attention to the mind as much as the aching muscles. As long as the source of the stress and its stressful perception remains intact, the pain will be challenging to treat or relieve, even with medications. Here are a few methods that can work:

  1. Rest. One of the most suggested methods to deal with stress and its attendant effects is rest. This usually involves taking a break from your stressful job, stepping out of a stressful environment, or taking a break from a toxic relationship. To deal with workplace stress, divert daily, withdraw weekly, and abandon annually.
  2. Stretches. While standing or even sitting, taking 10-15 seconds to stretch your neck in both directions once every hour reduces the tension built into them from routine tasks and sitting for too long. 
  3. Meditation or yoga. Whichever you are more comfortable with, stress-induced neck and shoulder pains can be reduced and even entirely healed by yoga-styled meditations that help the mind connect more functionally with the body
  4. Strategic relaxation. The whole goal of chronic stress management is to relax the mind and the body. Relaxing the body’s muscles can be carried out progressively by mentally focusing on one muscle at a time as you feel it tighten and then intentionally relaxes it.


In conclusion, stress-induced neck and shoulder pains are not just possible; they are prevalent in America and most parts of the industrialized world. They can result from physical or emotional stress from work, relationships, family, or academics. The most effective treatment therapies for stress-induced neck and shoulder pains help remove the stressors or provide better coping capacities for the patient.