Why stress makes you feel physical pain

Back pain could be a useful early warning sign for you and your employees, says AXA PPP's Jan Vickery.

by Jan Vickery
Last Updated: 20 Dec 2019

Have you ever noticed that when you’re stressed you tend to experience neck, back or shoulder pain? This is because stress can manifest as pain within the body and can itself be an important cause of musculoskeletal problems. 

When we get stressed, the body naturally releases certain hormones to prepare for a physical response – namely cortisol and adrenaline.  

Cortisol is known as the primary ‘stress hormone’ and affects a variety of bodily functions that are unnecessary in a ‘fight or flight’ situation, by shutting down the immune system, for example. Adrenaline is associated with the ‘fight or flight’ response and heightens blood pressure, increases heart rate and blood supply and causes the muscles around the spine to tense for the possible need to flee the source of stress.

Neither of these hormones is beneficial if present at high levels for prolonged periods and they can lead to physical symptoms such as muscle tension or pain. Simply thinking or talking about a stressful event can increase tension in the back muscles of patients with chronic back pain. 

In addition, it’s well established that people with poor musculoskeletal health are at a higher risk of experiencing mental health issues and, conversely, those with mental health issues are more likely to experience musculoskeletal problems. 

The body and brain link – why a holistic approach is required 

The close link between musculoskeletal and mental health means they should not be thought of as separate workplace health issues. For the sake of employees’ overall health, it’s important to be on the lookout both for physical and psychological sources of stress in the quest to get to the bottom of the underlying problem.

Worryingly, stress, anxiety and depression are still a big issue for employers. According to the latest Office for National Statistics survey, they accounted for 14.3 million lost working days in 2017. But reducing employee workplace stress levels can often be easier said than done and the adverse knock-on effects don’t stop at musculoskeletal health. 

When trying to tackle stress at work it’s imperative for managers to be able to identify when employees might be in need of extra help or support, as the effects of common stressors might not always be as obvious to the individual affected. 

5 stressors that could be affecting your workforce

Workplace stressors and their impacts might not always be as obvious as you think. And many of these stressors can be obstacles to being happy and well at work.


Demands made on staff at work are an obvious factor to consider when weighing up what might be making an employee feel pressured or stressed. But, on the other side of the spectrum, what if an employee doesn’t have enough to do? Trying to look busy when there’s not much to do can also be stressful and make time at work very difficult. 

Control over your day

As individuals, the amount of control and autonomy we have over the way we work can have a massive impact on our capacity to cope at work. Some people thrive having clear instructions and deadlines as they want to know exactly what is required from them while, for others, this may cause them to feel stifled, needing the freedom to decide how they want to approach something and the ability to set their own timeframes. 

Support and relationships 

The amount of support available is important in helping employees to enjoy and cope at work. Support can be formal or informal and can come from other colleagues and line managers as well as provided by HR teams. It’s also worth considering what support networks are available within the business and additional support that could be offered – for example, providing access to confidential counselling through an employee assistance programme. 

This leads to relationships at work. It’s vital for employees to feel comfortable to speak up at work to deal with conflict constructively and to tackle unacceptable behaviour. 

Work purpose 

It’s also essential for employees to clearly understand what their purpose is at work. Knowing how they fit into the bigger picture and what is expected of them, as well as what they can expect from their colleagues can help to minimise stress within the workplace. Is this clear in your business? 


Finally, coping with change can be stressful. It’s crucial that organisational changes are communicated clearly and that employees throughout the business know how it will affect them. If they’re not kept in the loop, doubts, rumours and needless worries can start creeping in. 

Agility and understanding are critical when identifying and resolving stressors in the workplace. Ultimately, employers who can adapt ways of working and management styles to suit employees’ different needs will have happier and healthier workforces. 

Jan Vickery is head of musculoskeletal health at AXA PPP healthcare

Image credit: David Hume Kennerly / Contributor via Getty images


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