Anxiety impacts every system in your body, which may lead to headaches, tension, or dizziness.

We’re all familiar with the racing and worrisome thoughts associated with anxiety. But did you know that anxiety can manifest in your physical body too?

When you’re anxious and stressed, your fight-or-flight response kicks into gear, releasing chemicals that can cause tension and pain in your body.

Anxiety that manifests in your body is called somatic anxiety. It may feel like a headache, tight shoulders, or an upset stomach. There are several things you can do to help release this body tension.

Somatic anxiety, or somatization, occurs when anxiety symptoms manifest in the physical body. Somatic means relating to the body.

Somatic anxiety is common. A 2020 study of health professionals during the COVID-19 pandemic found that among those with anxiety, 22.9% had somatic symptoms.

Anxiety affects all systems of the body including the following:

  • musculoskeletal system
  • respiratory system
  • gastrointestinal system
  • cardiovascular system
  • endocrine system
  • nervous system
  • reproductive system

Anxiety and stress can also contribute to or worsen chronic pain disorders, such as chronic fatigue syndrome or arthritis, making functioning more difficult.

The most common somatic anxiety symptoms include the following:

  • abdominal pain or an upset stomach
  • rapid, pounding, or irregular heartbeat
  • chest pain
  • fatigue
  • dizziness
  • insomnia
  • headaches, muscle aches, or tension
  • trembling or shaking
  • dry mouth
  • sweating
  • shortness of breath
  • feeling pins and needles

Specific anxiety disorders can have additional symptoms. Panic disorder symptoms might also include:

  • feeling like you’re choking
  • tingling sensations
  • becoming overheated or cold

Symptoms typically associated with anxiety and other psychiatric disorders, such as fatigue, dizziness, and headache, are among the most common reasons for nearly half of all primary care visits in the general population.

Unfortunately, evidence suggests high rates of missed diagnoses and misdiagnosis of generalized anxiety disorder (GAD) and panic disorder, because the symptoms are often attributed to physical causes.

Among 1,000 people in primary care, an older 2000 study found that 38% had at least one somatic symptom commonly seen with anxiety, but only 16% ended up being diagnosed with an organic disease within 3 years.

If you’re experiencing one or more symptoms without knowing what’s causing them, anxiety might be at play. Consider talking with a healthcare professional to explore whether an anxiety diagnosis is appropriate for you.

Treatment for anxiety symptoms may involve medication or psychotherapy.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is the most widely used evidence-based treatment for anxiety disorders.

The goal of CBT is to help you identify and change difficult or distorted thinking patterns. Not only is CBT good for changing anxious thoughts, but it may also help people deal with physical pain.


Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the first-line medications for adults with GAD. GAD is a common anxiety disorder, and it often presents with somatic symptoms.

SSRIs that are FDA-approved for anxiety include sertraline (Zoloft) and immediate- and extended-release paroxetine (Paxil, Paxil CR).

However, a 2016 trial of the SSRI paroxetine found that although it improves cognitive symptoms, it doesn’t appear to improve the somatic symptoms of anxiety and depression.

SNRIs that are FDA-approved for anxiety include venlafaxine (Effexor) and duloxetine (Cymbalta). Duloxetine is also approved to treat musculoskeletal pain.

GABAergic medications

GABAergic medications act on the body’s GABA (γ-Aminobutyric acid) system. GABA is the primary inhibitory neurotransmitter in the nervous system.

GABAergic medications include agents such as benzodiazepines (Xanax, Ativan), pregabalin (Lyrica), and gabapentin (Neuraptine).

While benzodiazepines are effective in reducing anxiety symptoms, their use is strictly limited due to the risk of misuse and severe side effects.


Beta-blockers, such as propranolol (Inderal LA), help block the effects of adrenaline and noradrenaline, chemical messengers that increase your heart rate and make you sweat or shake.

Alongside professional treatment, self-care strategies focused on reducing stress and making your body feel better can help with somatic anxiety symptoms.

1. Stretch

You can often reduce anxiety-triggered tension or muscle aches with gentle stretching.

Consider getting a yoga mat and doing easy stretches, such as touching your toes or clasping your hands behind your back, several times a day.

Focus on the body parts that feel the most tension. Try to take slow, mindful breaths throughout the stretch session.

2. Take a walk

If possible, go for a brisk walk or jump on a treadmill. Research shows that physical activity can reduce the symptoms of GAD and panic disorder.

3. Butterfly hug

This is a grounding technique to use when you’re feeling overwhelmed. Cross your arms over your chest with your fingers resting on your upper arms or shoulders. Breathe deeply through your nose, and then slowly tap your hands on your arms in an alternating fashion.

4. Body scan meditation

Lie down and mentally scan for tension or anxiety in your body, one part at a time.

Anxiety within your body might feel like an upset stomach, a clenched fist, a headache, or tight shoulders. Pause on each body part and observe whether you feel any tension.

If you do, practice releasing the tension and then relaxing that body part.

5. Green or herbal tea

Few things feel more soothing than a hot cup of tea when you’re feeling on edge. Consider choosing a tea that has anti-inflammatory properties, such as green tea or ginger tea.

Somatic anxiety is the physical manifestation of anxiety. This can feel like a headache, tight shoulders, upset stomach, or fatigue.

These symptoms are caused by your body’s fight-or-flight response being constantly activated. This releases chemicals that can cause pain and tension in your body, especially when it occurs over a long period of time.

Somatic symptoms can be painful, but with the right treatment, they can be reduced and even completely relieved.