Surprising connection between anxiety and back pain

Low back pain and anxiety frequently coexist, influencing symptom severity, functional capacity, sleep and the likelihood of persistent disability.

For clinicians, recognizing this relationship can help explain why patients with similar spinal findings sometimes report markedly different pain experiences and why symptoms may persist despite apparently reassuring imaging.

The relationship is clinically significant because anxiety can influence attention to bodily sensations, expectations of harm, muscle activity, sleep quality and pain modulation. Persistent pain can also increase anxiety by threatening mobility, employment, independence and confidence in recovery. These processes may reinforce one another over time.