News Psycotherapy

What relationship is there between anxiety, tension and neck pain?

Dott.ssa Francesca Cosentino

One of the most frequent phenomena that occurs when we experience anxiety is the tension of certain muscle groups. The daily tensions and the presence of some pathologies at the cervical level can determine a contraction and a state of tightening of the muscles of the neck, shoulders and head, and cause a physical symptomatology characterized by headache, dizziness, imbalance and a sense of instability.

In the anxious state there is an excessive feeling of alertness and disproportionate attention with respect to all normally neutral stimuli. In the case of patients with cervicalgia the anxious state is increased and constantly present and contributes to maintaining the disorder in the cervical level.

In chronic pathologies of the cervical tract, the symptoms can be different depending on the districts involved, in fact we can observe a state of chronic pain localized especially in the upper part of the body: in the neck, shoulders, up to the head with physical symptoms characterized by neuralgia, tingling or paraesthesia associated with imbalances in the nervous system.

The nerve structures found at the level of the cervical vertebrae become sensitized and in cases of inflammation they can give a symptomatology very similar to that of anxiety.
The problem is therefore two-way, cervicalgia caused by physiological factors can cause anxiety, and vice versa an anxious situation, especially if constant, causes tension in the cervical muscles.
All situations of imbalance and tension involve a contraction of the muscles and a diaphragmatic closure of breathing, which favors the onset of typical symptoms such as
  • dizziness
  • heeling feeling
  • heart palpitations
  •  sense of oppression
  • feeling of having an empty head
  • mental confusion
  • head and neck pain
The global physical and psychological approach to the patient with cervicalgia allows you to change the parameters that contribute to muscle and respiratory tension. In this approach, the psychophysical relaxation phase always starts with fluent diaphragmatic breathing, then a series of contractions and muscle relaxation, loosens the stiffness of the muscular districts involved.
The use of clinical diaries also allows the daily or weekly monitoring of the evolution of the physical symptoms in relation to the emotions and experiences experienced by the patient, as well as identifying the behaviors that contribute to the maintenance of the disorder.
Through subsequent cognitive and emotional processing, the patient can observe that pain related to cervicalgia often appears immediately before or after the anxious state. In most cases, anticipatory anxiety is present which promotes muscle tightening and pain.
Why is this happening?
Pain is a wake-up call that allows the individual to perceive an internal physiological discomfort, while the anxious symptomatology reflects the internal discomfort, therefore psychological therapy can also lead to an improvement in the organic state.
The patient often focuses on finding an understanding of physical or psychological causes, losing the overview and the multifactorial component of the painful condition.
The clinical diary allows the patient to observe their state of physiological tension and to understand which social, behavioral and psychological factors can contribute to the maintenance of pain. In cases of anxiety associated with cervicalgia, a baseline is performed at intervals, on specific scales and the behavior implemented by the patient is observed. The value of pain associated with personality factors, behavior and related to some psychophysiological data is then ascertained.
The patient is referred to a muscle rehabilitation treatment through specific physiotherapy techniques and at the same time, progressive muscle relaxation and psychological therapy are proposed.
The sensation mainly referred to in the post-therapy control by patients is to have a greater observation capacity and a better control of the pain until, in some cases, its total elimination. The ability to predict anxiety by controlling the tensions associated with psychological therapy allows more adaptive and functional behaviors and thoughts.
The symptomatology associated with cervicalgia improves significantly with the path where each patient finds his or her preferred methodology up to complete autonomy.