Why Anxiety Causes Chest Pain (And What You Can Do About It)

There are many physical symptoms that a person can experience when they suffer from anxiety. One symptom that is common in people who suffer from more chronic and severe cases of anxiety is chest pains. Chest pains can create several different types of sensations in the chest, upper back, and sometimes the shoulders, like:

  • Tingling
  • Shooting pain
  • Muscle tension
  • Twitching
  • Burning
  • Pressure
  • Numbness

Chest pains caused by anxiety are often mistaken for symptoms of a heart attack, but they are not dangerous. They are simply a reaction to anxiety. Cases of anxiety that commonly create chest pains include:

  • Panic disorder
  • Posttraumatic stress disorder
  • Severe cases of generalized anxiety
  • Phobias

Chest pains caused by anxiety can occur on their own or without an apparent trigger. It is difficult to live with experiencing chest pains because they can disrupt the quality of a person’s daily routine. The pain can sometimes become so severe that affected people end up visiting the emergency room because they believe they are experiencing a medical emergency. Though they are not dangerous, chest pains cause a great deal of anxiety and distress within a person, so it is important to understand what causes and alleviates them.

Why Do People Experience Chest Pains?

Chest pains caused by anxiety are felt as a result of two main causes: a stress response in the brain, called the fight-or-flight response, and acid reflux, or ‘heartburn’. Each causes different sensations within the chest. The fight-or-flight response is caused by tension in the muscles of the chest and upper back. Acid reflux is caused when the muscles in the stomach tense, causing pressure in the stomach. This causes stomach acid to travel up to the esophagus, causing a burning sensation.

The Fight-Or-Flight Response

Chest pains that are caused by anxiety are a result of the brain activating the ‘fight-or-flight’ response. When people are confronted with a trigger that causes anxiety, there is a stress response that is signaled through the brain. This signal activates the ‘sympathetic nervous system’, which is responsible for reacting to threats of danger. The fight-or-flight response will cause a person to feel a rush of adrenaline throughout the body, muscle tension, hyperventilation, and stomach pain, as the body enters a state of heightened sensitivity and alertness for signs of danger. The muscle tension in the chest, arms and stomach will result in chest pains. The adrenaline rush will also cause a person to feel tingling, pain and numbness in the chest and arms.

It is possible to experience chest pains as a result of the fight-or-flight response when there is no apparent reason for the sympathetic nervous system to be activated. Those who experience chest pains without being confronted by a trigger likely have an overactive nervous system that may be misfiring. This means that there is a ‘danger’ signal being sent through the brain and body, even if there is no treat of danger. Therefore, those who have chronic moderate to severe anxiety and experience chest pain even though there is not threat or trigger present have the potential to feel frequent, chronic, or recurring chest pain.

The longer anxiety is left untreated the more likely a person is to become more sensitive to the fight-or-flight response. The longer a person experiences the response without addressing the issues the more severely the condition will grow. The affected person will eventually begin to feel chest pain even without being triggered or feeling anxious. Tightening in the chest eventually becomes a habitual response that does not need to be triggered to occur.

Acid Reflux

Acid reflux is the second major reason behind chest pains caused by anxiety. Acid reflux is a stress reaction that is especially prevalent in those who suffer from an anxiety disorder. While acid reflux is not a regular occurrence within people who have anxiety, when it does affect an anxious person, the pain and discomfort can disrupt a person’s ability to function. It also has the potential to put the affected person at risk for ulcers or other stomach issues.

It is often easy to confuse acid reflux with other symptoms that cause chest pain, like hyperventilation and muscle tension. However, there are features that are indicative that a person is experiencing acid reflux, like:

  • A burning sensation in the stomach and throat
  • A sour taste in the back of the throat
  • Tension in the abdominal muscles
  • Upset stomach and indigestion

Acid reflux occurs as a reaction to increased stress that causes the stomach to produce more stomach acid and the abdominal muscles to tense. The increased stomach activity and tension of the stomach causes the stomach acid to travel up through the stomach and into the esophagus, causing the burning sensation.

Acid reflux occurs as a reaction to stress because stress affects the production and administration of hormones that regulate stomach acids and protect the stomach and esophagus from being harmed by the stomach acid that is at work. This process can be aggravated by a number of factors, including:

  • Fatigue, exhaustion, or lack of sleep
  • Poor diet that consists of fatty foods or foods with high acidic content
  • Poor coping skills for anxiety
  • Consistent exposure to high-stress situations
  • Depressed mood and mood swings

How To Manage Chest Pains Caused By Anxiety

When dealing with chest pains caused by anxiety it is important to be aware of the triggers that are causing you to be anxious. People who experience chest pains and acid reflux often have had recurrent exposure to triggers, resulting in the muscle tension and an increase in stomach activity. Once you are aware of your triggers it is important to take measures to prepare for exposure to the triggers. Counseling can help with learning coping strategies to manage triggers. Two common forms of therapy that help reduce anxiety and relieve the experience of chest pain are:

  • Cognitive behavioral therapy is a form of therapy that will help teach you how to handle your triggers through rationalizing and challenging negative thoughts that trigger the stress reaction. Cognitive behavioral therapy pinpoints the harmful effects of negative thoughts on your emotions and behavior. The skills learned in cognitive behavioral therapy will help you experience less anxiety when confronted by a trigger, which will diminish the emotional response. This will lessen the intensity of chest pains caused by anxiety.
  • Dialectical behavioral therapy is a form of therapy that teaches distress tolerance skills. With dialectical behavioral therapy you will learn how to cope with high stress situations, how to handle a crisis, and how to use deep breathing, meditation, and mindfulness exercises to relieve anxiety caused by triggers and chronic stress.

There are also lifestyle changes that are helpful in relieving the experience of chest pain caused by anxiety. If you suffer from anxiety-induced chest pains, consider making the following lifestyle modifications:

  • Drink plenty of water. Drinking water is important in the reduction of chest pains because staying hydrated helps regulate stomach functions. Drinking plenty of water will prevent the overproduction and release stomach acids that produce chest pains. It will also be helpful in reducing muscle tension because the muscles will stay hydrated and healthy.
  • Practice deep breathing exercises. Practicing deep breathing exercises are helpful in reducing chest pain caused by anxiety because not only does it bring oxygen to the muscles, causing them to relax, but it also forces those muscles to stretch. The stretching releases the tension that is causing the pain.
  • Take breaks during the day. It is easy to get wrapped up in all the stress a typical day brings. Between work, school, family, and friends, your day can quickly become overwhelming. In order to prevent getting overwhelmed and reduce your anxiety, remember to take breaks during the day. Taking 5 or 10 minutes in the middle of your day to relax your body and mind will reduce anxiety and relieve muscle tension. It will bring your mind back to a calm state, so it is not hypersensitive to stimulation. This will reduce the stress reaction, which will reduce the prevalence of chest pain. It will also help keep stomach functions regulated, reducing the chance of acid reflux.
  • Stretch. To relieve the tension that causes the pain in your chest, remember to stretch the chest, back, and shoulder muscles daily. Stretching these muscles on a daily basis will relieve pain caused by tension and prevent future pain from occurring.
  • Do not consume foods and beverages that have a high acid content. Foods with high acidity will aggravate acid reflux, which will increase the pain felt in the chest when in an anxious state. Staying away from foods that have a high acid content will decrease the acidity in the chest, preventing acid reflux. Foods and beverages that have a high acidic content include:
    • Coffee
    • Simple carbohydrates (white bread, white rice, and processed foods)
    • Sugar
    • Processed meats
    • Soda
    • Fruit juices
    • Fruits like lemons, grapefruits, and tomatoes
  • Instead, incorporate the following foods into your diet to regulate stomach acid:
    • Apple cider vinegar
    • Ginger
    • Herbal tea
    • Apples
    • Bananas