Chronic pain can exacerbate anxiety – and anxiety can worsen pain. Even anticipating pain will spike the nerves. Along with the proper therapy, supplements such as ashwagandha, melatonin and turmeric can help manage discomforts and aches.
September is National Pain Awareness Month, introduced by The International Association for the Study of Pain (IASP).
While chronic pain may feel isolated, in a real sense, it rides several of the same pathways as mood and stress-anxiety. There is a co-dependent relationship – anxiety and chronic pain are linked through a bidirectional, neurological feedback loop where each condition directly triggers, feeds, and intensifies the other. Neurologists at a Texas-based pain clinic explain, “The brain’s amygdala and insula process pain and anxiety. When you’re anxious, these areas become hyperactive. This hyperactivity makes pain signals feel stronger. This overlap can turn minor discomfort into chronic pain.”
Another link between pain perception and anxiety is hormonal and neurochemical imbalances. Chronic stress and anxiety deplete serotonin and endorphins, neurotransmitters that lessen pain and regulate mood, as well as lead to excess cortisol, adrenaline and substance P production, creating inflammation and intensifying pain.
Nervousness tends to cause the body to tense up. Prolonged tension leads to localized soreness, and spasms, particularly in the neck, shoulders, and lower back. Further, explain researchers, “chronic stress has been reported to lead to hypothalamic–pituitary–adrenal axis and autonomic nervous system disruption, which may in turn induce systemic proinflammatory conditions.”
For those with chronic pain due to a variety of causes, anxiety ticks up, and the combination tends to ruin sleep, and reduce quality of life. Lack of restorative sleep prevents tissues from healing and drastically lowers a person’s pain threshold the next day. Additionally, pain and stress can cause a cognitive fog, characterized by impaired memory, reduced focus, and challenges in quick decision-making.
Four Steps to Feeling Better
Stress and to some extent, anxiety, are unavoidable. However, they can be managed or reduced through several non-invasive techniques as well as supplementation.
- Mindfulness and Meditation: Practicing mindfulness, deep breathing, and meditation help divert attention away from pain. Studies have shown that mindfulness-based stress reduction (MBSR) can reduce both pain intensity and anxiety levels. For example, a large-scale meta-analysis of 68 studies with 5,339 participants confirmed that standard MBSR programs achieved the most promising results for reducing chronic pain perception. The authors found that after 8 weeks of engaging in MSBR daily for 90 to 120 minutes was the most effective mindfulness dosage. They write, “Our findings contribute to the evidence supporting the use of MBIs [mindfulness-based interventions) in in chronic pain management.”
- Exercise: Although it may sound counterintuitive, exercising – even just walking or doing yoga regularly – relieves muscle tension, reduces anxiety and decreases pain intensity. A meta-meta-analysis that assessed data from 157 systematic reviews covering 2,736 randomized controlled trials with 221,279 participants conclusively demonstrated that physical exercise significantly reduces clinical pain across diverse musculoskeletal, neurological, inflammatory, and cancer populations. The authors write, “This umbrella review provides compelling evidence that exercise offers consistent and clinically meaningful pain relief across diverse populations and conditions. Findings support the integration of even low-intensity, short-term exercise into routine pain management strategies.”
- Follow a Healthy Diet: The diet most effective at managing pain is one containing anti-inflammatory foods, and which avoids inflammation-causing products like red meats (arachidonic acid). An anti-inflammatory diet is rich in omega-3 essential fatty acids (salmon, flaxseeds walnuts), polyphenol-rich fruits (berries, citrus), leafy green vegetables, monounsaturated fats from extra virgin olive oil, and anti-inflammatory spices such as turmeric. Authors of a systematic review find that incorporating foods containing anti-inflammatory nutrients leads to a reduction in pain severity and interference. Other studies in specific populations show pain-reducing benefits of this diet. For example, following an anti-inflammatory diet significantly reduced pain compared to ordinary diet in participants with rheumatoid arthritis.
- Supplementation: Several dietary supplements may benefit healthy people dealing with chronic discomfort and anxiety.
Omega 3 EFAs – For individuals who dislike fish and are not consuming enough DHA and EPA regularly, supplements have been shown to greatly decrease discomfort and aches. In one review of 41 RCTs, omega-3 EFA supplementation showed statistically and clinically significant reduction in pain intensity, and the relief was generally felt at approximately 1 month of supplementation.
Ashwagandha – Ashwagandha root (Withania somnifera) improves resilience by reducing stress, anxiety and cortisol production. Ashwanova™, also known as Prolanza™ is a well-researched, sustained-release root-only ashwagandha extract distinguished by its once-daily low-dose clinical efficacy. A new study showed that moderately stressed participants had substantial increases in Perceived Stress Scale score at 150 mg (2.7) and 300 mg (3.1), as well as self-reported improvements in sleep quality and happiness. Further, the 300 mg dose significantly reduced serum cortisol levels by day 60, indicating a biological effect on stress regulation.
Melatonin – This well-proven sleep-health supplement is pertinent to a pain- and anxiety-reduction program. Melotime™, shown in a pharmacokinetic study to more closely mimic the body’s natural overnight melatonin secretion profile, also has new human clinical research confirming its ability to improve sleep quality and extend sleep duration. Participants taking Melotime experienced a measurable increase in total sleep time over the 28-day study period, while placebo group showed a net decline. This difference continued to widen throughout the study period, which suggests sustained improvement with continued supplementation. Melotime also significantly reduced sleep onset latency, which worsened in the placebo group. Additionally, Melotime significantly reduced wake after sleep onset (WASO), meaning participants spent less time awake after initially falling asleep, helping preserve slow-wave (deep) sleep patterns.
Turmeric – Along with Omega-3 EFAs, turmeric is one of the most powerful natural anti-inflammatory ingredients. While most turmeric supplements necessitate high doses (1000 to 2000 mg) for any effect, water-dispersible TurmXTRA™ active has been shown to work with only a 250 mg once-daily dose (150 mg curcuminoids).
In one study, 69 women with mild to moderate knee OA consumed low-dose TurmXTRA active for 90 days. After only 60 days, participants showed a significant reduction in Visual Analogue Scale (VAS) scores, a measurement of pain. Furthermore, significant improvements were observed as early as 30 days in Knee Injury and Osteoarthritis Outcome Score (KOOS) domains including pain, symptoms, activities of daily living and quality of life. This study substantiates findings from an earlier study in which 250 mg of TurmXTRA active taken for 90 days alleviated knee discomfort, as demonstrated by improved performance on an 80-meter fast-paced walk test and 9-step stair-climb test. TurmXTRA active also improved all inflammatory biomarkers compared to placebo.
Conclusion
According to the CDC, approximately 24.3% of American adults are living with chronic pain, while 8.5% have chronic pain that limits work and life activities. Anxiety is one of the top conditions caused by pain and is often noted as a co-occurring symptom. Taking measures such as engaging in mediation, mindfulness, exercise and supplements can help make life easier.
Reviewed by Sneha Sawant Desai, PhD
