You’re not imagining it. Stress and back pain often go hand in hand. That dull ache in your lower back or tightness across your shoulders could be your body reacting to mental and emotional pressure (not just physical strain).
At Integrity Physiotherapy, we see this pattern often. Patients come in thinking they’ve “pulled something” only to realise that it’s not one big movement causing the problem, but a build-up of stress, tension, and nervous system overload.
This blog looks at how stress and back pain are connected, what it might feel like, and how physio can help settle things down and get you moving again.
What’s the link between stress and back pain?
Stress can contribute to back pain by causing muscle tension, increasing pain sensitivity, affecting posture, and triggering inflammation in the body. This pain includes a mix of dull aches, sharp twinges, muscle tightness, and general discomfort, often felt in the neck, shoulders, and lower back. When stress becomes chronic, it can exacerbate these issues, potentially resulting in chronic low back pain.
Here are some of the ways stress can lead to back pain through physical changes in the body.
Muscle tension
- Stress causes muscles to tighten, particularly in the neck, shoulders, and back. This ongoing tension can create stiffness, soreness, or sharp pain.
Increased pain sensitivity
- The nervous system becomes more reactive under stress, which means you may feel pain more intensely than usual, even from mild triggers.
Inflammation
- Chronic stress can disrupt the body’s ability to regulate inflammation, contributing to pain in joints and soft tissue, especially around the spine.
Postural strain
- When stressed, people often slouch, hunch their shoulders, and breathe less effectively. Over time, this puts extra load on the back.
Reduced circulation
- Stress can narrow blood vessels, limiting oxygen flow to muscles and leading to fatigue, tightness, and slower recovery.
The stress–pain cycle
- Pain adds to stress, and stress adds to pain. When not addressed, this loop can keep your body in a state of ongoing tension and discomfort.
How stress shows up in your body
When stress sticks around, it tends to settle into the body in a few common ways:
- Tight shoulders and jaw: Clenching, shrugging, or holding tension without noticing.
- Upper back strain: Shallow breathing and poor posture often show up here.
- Lower back tightness: Less movement, more bracing, and increased stiffness around the spine.
- Muscle spasms: Sudden, sharp contractions or cramping can occur when tension builds up and muscles don’t get a chance to properly relax.
- Morning soreness: Waking up tight or achy, even if you haven’t done anything physical the day before.
- Ongoing fatigue: The body stays in “alert mode”, draining energy and making you feel heavy or worn down.
Why it’s not just ‘in your head’
Back pain linked to stress is real. It’s not imagined, and it’s not a sign of weakness. The nervous system and musculoskeletal system are deeply connected — so when stress takes hold, it can show up physically just as much as emotionally.
For some people, the nervous system becomes overly sensitive over time. This means the body starts reacting to smaller triggers, and even mild tension or movement can feel more intense than usual. This process is known as neuroplastic or nociplastic pain and the mechanism is called central sensitisation, and it can keep pain lingering long after the original cause has passed.
By recognising this link, we can treat what’s going on in the body while also helping the nervous system settle, which is often where longer-term relief starts.
Signs your back pain could be stress-related
It’s not always easy to tell what’s causing your pain. But there are a few patterns that suggest stress could be playing a role.
- The pain comes and goes depending on what’s happening in your life
- It feels worse during busy or emotionally loaded periods
- You wake up feeling stiff or sore even if you haven’t done much physically
- There’s no clear injury or event that caused it to start
- It feels better after movement, rest, or relaxation
- Manual therapy helps, but the pain returns when stress builds again
Stress is one of several risk factors for ongoing back issues, particularly when it’s paired with poor posture, sleep disruption, or low activity levels. Recognising these links early can help shape a more effective treatment plan.
How physiotherapy helps
When stress is contributing to back pain, physiotherapy plays an important role in breaking the cycle. Treatment focuses on both the physical symptoms and the underlying drivers that keep your body stuck in a state of tension.
At Integrity Physiotherapy Como, we often start with hands-on techniques to release tight muscles and improve joint mobility. This can help settle the immediate discomfort and make movement easier. From there, we build in gentle exercises to restore strength, improve posture, and specific strategies to help your nervous system calm down.
We also look at the patterns contributing to your symptoms — whether it’s prolonged protective postures during sitting, bracing habits, shallow breathing, or a lack of movement in your day. With the right guidance, small changes in how you move and hold yourself can make a big difference in how your back feels.
Physiotherapy can provide strategies to teach your body to let go of tension, so it doesn’t have to live in that compressed heightened state all the time. With less strain and more movement, the nervous system can start to settle and pain becomes easier to manage.
Tips to ease both stress and back pain at home
There’s no one-size-fits-all solution, but small changes to your routine can often make a difference. If your symptoms tend to flare when life gets busy, finding simple ways to reduce stress can make a noticeable difference.
Here are a few ways to support your body and reduce strain.
Move regularly
- Even a short bursts of physical activity like walking, gentle stretching, or standing up between tasks can help break up tension and support healthy movement.
Pay attention to posture
- Try to keep your spine in a neutral position when sitting or working. Use a chair with support, and keep screens at eye level where possible.
Breathe
- Slow, deep breathing helps calm the nervous system. It’s simple, but often overlooked when stress builds up.
Create a wind-down routine
- Reducing screen time before bed, doing light movement in the evening, or setting aside time to switch off can help the body relax overnight.
Stay hydrated and eat well
- Supporting your body with the basics makes it more resilient to both physical and emotional stress.
Consider Yoga, meditation, somatic tracking or somatic awareness
- Begin yourself or your Physio can guide you with simple practices to start calming your nervous system to reduce tension.
You don’t need to aim for a completely stress-free lifestyle (that’s not realistic for most people). But creating space to unwind and reset can make a real difference to how your body feels.
Ready to break the stress-pain cycle?
If your back pain isn’t improving, keeps coming back, or flares up during periods of stress, it’s worth reaching out. You don’t need to wait until it’s severe or constant. The sooner you catch it, the easier it usually is to treat.
Here at Integrity Physiotherapy, we offer physiotherapy for back pain in South Perth that focuses on what your body needs to move and feel better. We’ll help you work out what’s behind the pain and put together a plan that actually fits into your life.
Book your appointment today and let’s get you moving again.
