Pain & anxiety - when the body sounds the alarm

"I'm in constant pain - but all the examinations are normal."
"My heart is racing, my chest is constricting, I can't breathe - and nobody can find anything."
"I wake up at night, completely cramped. Everything hurts. And I'm terrified."

We hear statements like this again and again in therapeutic practice. And they show that pain is not just a physical event. It is a warning signal - and often part of a much larger, inner state of alarm.

Generalized anxiety disorder & panic attacks - the vegetative system in constant arousal

Anxiety is a physiological reaction. However, in people with generalized anxiety disorder (GAS) or recurring panic attacks, the nervous system remains permanently on heightened alert. This means that

  • The sympathetic nervous system is chronically active

  • Muscles remain tense

  • Breathing becomes shallow and hectic

  • Digestion, sleep, recovery - everything becomes secondary

What remains is a body in a state of emergency. And this state is painful - on many levels.

Pain as the physical language of fear

The patients report on:

  • Tension headaches and migraines

  • Neck pain, teeth grinding, CMD

  • Back pain with muscular imbalances

  • Chest tightness, shortness of breath, palpitations

  • Gastrointestinal complaints through to irritable bowel syndrome or chronic constipation

All of this is real - even if no structural cause is found.

What can therapy achieve?

In physiotherapy and occupational therapy, we have no direct influence on anxiety - but we do have an influence on the system in which it operates. And this is exactly where our leverage comes in.

Therapeutic goals can be

  • Regulation instead of control

  • Trust instead of reinsurance

  • Perception instead of avoidance

  • Safety instead of speed

What helps?

  • Gentle breathing work to regulate the vegetative system

  • Touch-based therapy that conveys safety

  • Body awareness training to recognize anxiety earlier

  • Movement at the client's pace, not to the beat of the therapy plan

  • Educational approach to pain and anxiety patterns - without pathologizing them

Attitude instead of technology

For people with anxiety and panic disorders, our therapeutic approach is often more effective than any method. A safe space, a reliable rhythm, a calm tone of voice - these are all interventions that cannot be mapped in techniques, but have a profound effect.

Conclusion:
Anxiety and pain are close relatives. If you understand the nervous system, you can deal with both - with respect, clarity and a deep understanding that the body is not crazy. It protects.

📅 Webinar tip:
"Pain & anxiety - when panic controls the body"
A 60-minute webinar on autonomic regulation, physical safety and therapeutic support for anxiety disorders and panic attacks.
To register: www.hockenholz.com/webinare

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Pain and ME/CFS - When even rest is exhausting