Can depression cause physical pain?
Depression affects more than your mood — it can cause physical symptoms like pain. Here’s how the two connect and how you can find relief.
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Depression isn’t all in your mind. Along with its impact on your emotions, mood, and mindset, it often shows up in your physical health, too. You might notice changes in your sleep, deep fatigue, or digestive issues, but one of the most common physical symptoms is pain. Estimates vary, but research suggests that anywhere between 40% and 80% of people with depression also report physical pain.
That’s because depression and pain have a powerful mind-body connection. In fact, describing pain as just a "physical symptom" is something of a misnomer. Pain — whether in your back, head, or joints — is a biopsychosocial experience. This means it isn't just about what is happening in your tissues; it’s deeply influenced by your stress levels, emotional state, and environment. These factors create a cycle where depression influences pain levels, and pain, in turn, affects mental health.
Often, physical symptoms, such as muscle tension, restless sleep, or gastrointestinal issues can be an early clue that someone is experiencing depression. That’s why healthcare providers routinely check mental health when treating pain. Diagnosis is the first step toward relief, as comprehensive treatment can significantly improve your long-term health.
Because pain and depression are so closely linked, treating depression often has positive “crossover” effects on pain. “Since depression and pain often go hand-in-hand, treating one may help treat the other,” says Natalie Palmer, a health coach at Hinge Health.
Read on to learn more about how depression and pain develop together and how simple strategies, including gentle movements recommended by Hinge Health physical therapists and lifestyle modifications, can help ease symptoms.
How depression causes physical pain
The connection is complex, but the main thing to know is that your brain chemistry plays a key role. The same brain chemicals (neurotransmitters) and many parts of the brain that regulate mood also influence how we feel pain. “Changes in these brain chemicals can influence your pain sensitivity, making you feel physical discomfort more intensely,” Palmer says. Here are common factors that contribute to this between depression and pain:
Neurochemical changes. Brain chemicals like serotonin, norepinephrine, GABA, and glutamate help regulate both your mood and perception of pain. When these levels change, it can affect both your emotional state and how your body processes pain signals.
Inflammation. Persistent inflammation — from sources like stress or other health conditions — can affect the brain and contribute to both depression and physical pain.
Psychological factors. Stress is a trigger for depression. By increasing muscle tension and inflammation, stress can also amplify your perception of pain, making minor issues feel more severe.
Brain activity. Depression can alter how the brain processes mood and pain signals, linking the two experiences more tightly.
Pain sensitivity. Depression can sensitize your nervous system, meaning you might feel pain more acutely or notice discomfort you might otherwise tune out.
Physical symptoms of depression
Along with mood changes, depression can show up in the body in many different ways. These symptoms often include fatigue, physical discomfort, and changes in sleep or eating patterns. Not everyone with depression experiences all of these physical symptoms, but they can include:
Fatigue. Feeling exhausted constantly is common with depression. “It can feel like a depletion of energy,” says Palmer. This exhaustion doesn't just affect your motivation; it impacts how your body feels. When you are fatigued, your body has fewer resources to manage stress and sensation, which can make physical pain feel more intense.
Sleep problems. Depression often changes sleep patterns, making it hard to fall and stay asleep or causing you to sleep more than usual. This lack of restorative rest can actually increase pain sensitivity. “When you don’t feel well-rested, your nervous system may be more sensitive to pain,” says Palmer.
Aches and pains. Depression and pain share similar chemical and structural pathways in the brain. This can make your nervous system more sensitive to discomfort, leading to body aches, back pain, or stiff joints without a specific injury.
Muscle tension. The emotional stress associated with depression can cause the body to unconsciously "guard" or hold tension. This leads to persistent muscle tightness, particularly in the back, shoulders, and chest which can feel stiff and uncomfortable. (Always consult a doctor about chest pain to rule out an underlying condition or cardiac event.)
Gastrointestinal (GI) issues. Depression can affect digestion, which can lead to GI symptoms like abdominal pain, constipation, and heartburn. Research suggests that up to one-third of people with irritable bowel syndrome (IBS) — a condition characterized by unexplained stomach discomfort —also experience depression.
Loss of libido. A reduced interest in sex is common with depression, which can strain relationships and further contribute to downward cycle in mood and pain.
How movement can help pain and depression
Being physically active when you have depression or pain can be challenging — fatigue and pain can make exercise feel impossible. It can also affect your motivation to work out. But as Hinge Health physical therapists say, movement is medicine — for your body and mental health. Research shows that physical activity helps balance mood-regulating chemicals, reduces stress hormones and inflammation, enhances sleep, and calms your nervous system. This is especially beneficial if you are living with chronic pain. Studies suggest that people with higher pain levels often see the greatest improvements in their mental well-being when they get moving.
“While no specific exercise ‘cures’ depression, targeted, gentle movements like the ones below give you a chance to connect with your body, without demanding a whole lot of effort,” says Victoria Smith, PT, DPT, a physical therapist at Hinge Health.
Gentle exercises to help ease tension
Want expert care? Check if you're covered for our free program →- Diaphragmatic breathing
- Pelvic tilts
- Cat cow
- Chin Tucks
- Child’s pose
- Scapular squeeze
Small, mindful movements can make a big difference in how you feel. These gentle exercises are designed to help soothe your nervous system and reconnect you with your body. Start by doing one or two of the above movements — even a little bit of movement can help interrupt the cycle of pain and tension.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Treatment options for physical symptoms of depression
A variety of tools can help treat the physical symptoms of depression. Taking medication, talking to a mental health professional, and eating healthy can all help your body and mind. Consider the following strategies:
Stay active. Movement can have a positive impact on your mood. Even a few minutes of exercise can help release feel-good endorphins, blocking pain signals and supporting your overall well-being. “Movement isn’t a cure-all, but it’s incredibly effective when paired with other treatments,” says Dr. Smith.
Try psychotherapy. Counseling with a trained mental health professional is a proven way to reduce the physical and emotional pain of depression. Cognitive behavioral therapy (CBT)-related techniques in particular can be very helpful as they encourage people to recognize and reframe negative thought patterns. It’s a well-established treatment for depression and chronic pain.
Ask your doctor about medication. Some medications, including certain antidepressants, may be effective for easing physical pain from depression because they influence the same neurochemicals that affect your mood. There are medications that can help address both pain and mood.
Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can stay active when you have muscle or joint discomfort. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.
Make lifestyle modifications. A nutrient-rich diet — including fruits, vegetables, whole grains, and healthy fats — can support a stable mood. Adopting sleep hygiene skills, like powering down screens and keeping your bedroom cool, can also help break the cycle where poor sleep influences mood and pain.
Apply heat or cold therapy. Heat can help soothe tension in sore or achy muscles whereas ice can help numb pain and make you feel more alert, Dr. Smith says. Try either or both methods when you feel pain.
Adopt stress reduction techniques. Research suggests that regularly doing yoga and meditation, as well as tai chi, can reduce symptoms of pain and depression. Deep breathing techniques, like diaphragmatic breathing, show similar benefits.
Lean on your support systems. “It’s important to stay connected to family and friends, even when you don’t feel like socializing,” says Palmer. Engaging in low-key social activities, like movie nights, video chats, or hobbies with a friend can help counter the isolation that often worsens both depression and pain.
Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for muscle tension relief, such as massage, acupuncture, or chiropractic care.
Regular exercise reduces stress, improves mood, and boosts overall well-being. It also helps relieve pain, which can get in the way of doing what you love. An exercise therapy program can help you feel better.
Hinge Health members can access customized plans and chat with their care team. They experience an average 68% reduction in pain* within the first 12 weeks—and those with mental health symptoms experience a 58% average decrease in anxiety and depression. Learn more*.
When to see a doctor
You should see a medical professional about depression and pain if you have symptoms most of the day, every day, for at least two weeks, or if your symptoms interfere with your daily life. Combined treatment for depression and pain can be very effective. You can start by talking to your primary care provider, who can refer you to a mental health professional.
PT tip: Start slowly with exercise
Starting an exercise routine may not be easy if depression is causing physical symptoms — but even taking a small movement snack break during your workday can help ease symptoms. “Anything that gets your body moving can help with mood,” says Dr. Smith. Start with just a few minutes of daily movement that you look forward to, such as walking, gardening, yoga, pickleball. “That enjoyment motivates you to stay consistent with it,” Dr. Smith says.
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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