How to relieve tension in neck and shoulders from anxiety

If anxiety leaves your neck and shoulders feeling tense and painful, you're not alone. Stress triggers your body’s natural fight-or-flight response, which often leads to muscle tension — especially in your neck and shoulders. Over time, this can create a cycle where stress tightens your muscles, causing discomfort that makes it even harder to relax. “It takes a lot of energy to be in pain, so you might also have an overall lack of energy for other things,” says Katie Schaner, PT, DPT, a physical therapist at Hinge Health.

Fortunately, there are simple ways to break this cycle and find relief. Movement is one of the most effective tools. “Our bodies were designed to move, but when things hurt, we tend to move less, which makes muscles tighter and more painful,” says Dr. Schaner. Activities like walking, physical therapy exercises, and yoga are not only anxiety relievers but also effective for loosening tight muscles.”

Read on to learn more about the link between anxiety and neck and shoulder tension, and how to relieve tension in your neck and shoulders from anxiety with tips from Hinge Health physical therapists. 

Can anxiety cause neck and shoulder tension?

Absolutely. Stress and anxiety activate your body’s fight-or-flight response, causing muscles to contract as part of a natural reaction to perceived threats. “Whenever the fight-or-flight response is stimulated, a whole host of physiological changes occur,” explains Dr. Schaner. These include muscle tension, rapid breathing, increased heart rate, and elevated blood pressure. While this response helped our ancestors escape immediate dangers, modern stressors like deadlines and traffic can repeatedly activate it, keeping neck and shoulder muscles tense for extended periods.

Breathing patterns also play a role in anxiety-related muscle tension. The shallow, rapid breathing triggered by stress and anxiety reduces movement in your rib cage, which can lead to further tightness in your upper body. “When we’re not moving our ribs as much, it sets off a cascade of things tightening up in the upper half of the trunk,” says Dr. Schaner. This lack of rib movement forces your head to work harder to stay balanced, adding to muscle fatigue. “Picture your rib cage as a sturdy base that supports your head,” says Dr. Schaner. “When you breathe deeply, the expansion and contraction of your ribs creates a solid foundation so you don’t have to rely on tense muscles to keep your head up.”

How to relieve tension in neck and shoulders from anxiety

The fight-or-flight response, meant to protect your body, can often backfire, leading to persistent neck and shoulder tension. The longer stress remains high, the more pronounced this tension becomes. “Our body is super adaptable, but if muscles stay tight for too long, it can take time for them to relax,” says Dr. Schaner. Here are effective strategies to ease neck and shoulder tension. 

• Work with a physical therapist. Anxiety can impact your posture, breathing, and muscle function. A physical therapist can assess your needs and create a plan to strengthen and stretch key muscles. “Your symptoms should get better as your strength and mobility improve,” says Dr. Schaner. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Move more. Anxiety can lock your body into a "freeze" response, but movement helps counteract this. “Our bodies were designed to move, and any movement that feels good can help release muscle tension,” says Dr. Schaner. Physical activity improves circulation, reduces resting muscle tightness, and prevents stiffness. “Just do something, whether it’s walking your dog, Zumba, Pilates, or weight lifting. And if it’s fun for you, all the better,” she adds. 

• Do neck stretches. “Our vertebrae are designed to move in many directions — tilt, rotate, bend, and flex,” says Dr. Schaner. Gentle, frequent neck movements (no fancy techniques required) can ease tension and improve flexibility.

• Try a massage. Massage promotes relaxation by boosting circulation and increasing muscle temperature. While you can always visit a professional, self-massage tools like a foam roller, massage gun, or massage cane can be highly effective, too. 

• Use heat therapy. Applying heat increases blood flow to tight muscles, helping them relax. Try a warm bath, warm compress, heating pad, or hot shower to relieve tension.

• Practice relaxation techniques. Deep breathing and meditation can calm your fight-or-flight response and promote whole-body relaxation. Techniques like progressive muscle relaxation and diaphragmatic breathing are particularly effective at reducing tension in the neck and shoulders. “Any sort of deep breathing or meditation helps tamp down the fight-or-flight response and relaxes your whole system,” says Dr. Schaner.

5 tips for tension relief

While short bursts of stress can boost focus and motivation, chronic stress often leads to issues like neck and shoulder tension. But these physical therapist-recommended lifestyle changes can help manage anxiety and keep tension at bay.

1. Prioritize sleep. Sleep is essential for both mental and physical recovery. Plus, research shows that lack of sleep increases the risk of anxiety symptoms. “Sleep is when your body recharges,” says Dr. Schaner. Aim for seven to nine hours per night to allow your body and muscles to reset. 

2. Take movement breaks.“Dealing with neck and shoulder tension isn’t a stretch-once-and-you’re-fixed kind of thing,” says Dr. Schaner. Frequent, short bouts of movement throughout the day are more effective. To make it a habit, pair stretching with a daily routine, like stretching before meals.

3. Spend time outdoors. Nature naturally reduces tension. “Even sitting on a park bench and staring at a tree can calm your nervous system,” says Dr. Schaner. Exposure to sunlight boosts serotonin levels, improving mood. Combine outdoor time with physical activity for added benefits.

4. Eat to support relaxation. Choose high-fiber foods to stabilize your blood sugar and omega-3-rich options like fish and nuts to improve your mood. Foods rich in magnesium (e.g., seeds, nuts, beans) can help muscles relax and reduce stress. Dr. Schaner also advises limiting sugar intake, as it can be inflammatory. “Most people have more aches and pains when they eat a high-sugar diet,” she says.

5. Adjust your workspace. Small ergonomic changes can reduce neck and shoulder tension. “Even putting your monitor on a book to bring it to eye level can make a big difference,” says Dr. Schaner. 

PT tip: Stick with it

“Muscles respond well to consistent movement, so don’t be discouraged if neck tension doesn’t improve right away,” says Dr. Schaner. “You may start to notice small changes in a few weeks — like moments or stretches of time with less discomfort.” These shifts suggest your body is beginning to adapt. With regular practice, you may feel more noticeable improvements over four to six weeks, though occasional setbacks are normal. “Healing isn’t linear, but knowing that can help you stay on track,” says Dr. Schaner. 

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.

References 

1. Winerman, L. (2023, December 21). Sleep deprivation makes us less happy, more anxious. American Psychological Association. Retrieved from https://www.apa.org/news/press/releases/2023/12/sleep-deprivation-anxious

2. Sjörs, A., Larsson, B., Persson, A. L., & Gerdle, B. (2011). An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain. BMC Musculoskeletal Disorders, 12(1). doi:10.1186/1471-2474-12-230

3. Daher, A., & Halperin, O. (2021). Association between Psychological Stress and Neck Pain among College Students during the Coronavirus Disease of 2019 Pandemic: A Questionnaire-Based Cross-Sectional Study. Healthcare, 9(11), 1526. doi:10.3390/healthcare9111526