Most of us are familiar with the mental challenges that OCD can bring — but the condition can cause physical pain, too.

Obsessive-compulsive disorder (OCD) is a mental health condition that involves obsessive thoughts and compulsive, repetitive behaviors.

While people often talk about the emotional and mental effects of OCD, its physical effects are often left out of the discussion.

Compulsions like handwashing can physically hurt your hands, self-soothing behaviors like hair-pulling can harm your skin, and studies have also linked OCD with chronic pain.

When OCD has harmful effects on your body, it can help to build certain self-care methods into your treatment plan and daily routine.

Here are five ways that OCD can be related to physical pain:

Compulsions are repetitive behaviors that you perform to relieve anxiety.

You might feel that if you don’t do a behavior a certain number of times, or for a specific length of time — like washing your hands — then something bad will happen. You might feel compelled to repeat this behavior tens or hundreds of times.

The drive to engage in a compulsion is so strong that people continue to perform them despite them causing negative health effects or physical pain. For example, compulsions can cause pain by leading to:

  • hurt or bleeding hands from compulsive handwashing
  • the use of harmful chemicals to clean your clothes or skin
  • wrist pain or repetitive strain injury from compulsions that involve twisting your hands, such as checking that doors, windows, or faucets are properly closed
  • back or neck pain from repetitive body movements
  • physical exhaustion from spending time rearranging or reorganizing things until they feel “just right”

In addition, self-soothing behaviors like hair-pulling (trichotillomania), biting your nails, or picking at your skin — all of which can be related to OCD — can cause pain that may persist.

According to Mental Health America, there’s a strong connection between chronic pain and mental health conditions, including anxiety and depression.

While OCD isn’t officially classed as an anxiety disorder in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), OCD usually involves a significant amount of anxiety.

It’s well established that anxiety can have both mental and physical health effects, partly due to high blood levels of a stress hormone called cortisol. The physical effects of anxiety can show up in OCD, too.

The physical effects of anxiety can include:

  • headaches or migraine
  • aches and pains
  • digestive issues
  • nausea
  • pins and needles sensation

The close relationship between OCD and anxiety could mean they share similar comorbidities (accompanying conditions), too. A 2015 study reports that there is significant overlap between OCD and anxiety disorders.

According to the Arthritis Foundation, anxiety and arthritis commonly occur together. They further note that the two conditions can fuel each other, with anxiety making the pain seem worse and the pain making the anxiety or, by extension, OCD worse.

A 2014 study notes that OCD, the fourth most prevalent lifetime psychiatric disorder, has links with chronic pain. The researchers note that OCD receives less research attention than other mental health conditions with relation to chronic pain.

They also noted that cultural factors, as well as underdiagnosis of chronic pain, could account for the lack of studies or understanding of the connection between OCD and chronic pain.

Self-harm is the act of purposefully harming your body in some way. In many cases, self-harm is a coping mechanism to help you deal with difficult emotions or intrusive thoughts.

Some people with OCD have intrusive thoughts about harming themselves or others. This symptom is sometimes called self-harm OCD.

Like other symptoms of OCD, treatments like exposure and response therapy (ERP), can help you deal with these distressing symptoms.

In some cases, OCD can cause you to over-focus on physical sensations, which may amplify feelings of pain because you’re focusing attention on the pain.

According to the Anxiety & Depression Association of America, OCD can manifest not just through disturbing thoughts, but through physical sensations, too.

Focusing on a sensation could mean you focus on a physical need, such as the need to urinate. Or you may focus on an ache in the back, worrying that this means there’s something is seriously wrong.

In this way, people with OCD can also have illness anxiety disorder, which is a fear that your bodily sensations are signs of an illness.

In a 2019 review of studies, researchers looked across 14 different studies addressing perceived pain in people living with OCD. They found that people with more severe cases of OCD had a poorer self-reported health status.

The researchers concluded that doctors and practitioners need to be mindful of not ignoring the perception of physical pain or other issues when treating patients.

Treatment for OCD will vary between people based on their individual symptoms. In some cases, physical pain symptoms may improve or disappear when you receive effective treatment for your symptoms of OCD.

If you have an existing chronic pain condition, like arthritis, it’s important to discuss the best treatments and pain relief options with your healthcare team, too.

According to the International OCD Foundation, the two most successful methods used to treat OCD are:

  • Cognitive behavior therapy (CBT). A type of CBT called exposure therapy (ERP) can help. This involves exposing a person to their triggers and working directly with a mental health worker to change their response to the stimuli.
  • Medication. In addition to ERP, a doctor may recommend you take certain serotonin reuptake inhibitors (SRI) or selective serotonin reuptake inhibitors (SSRIs). Many people find benefits from taking medications in conjunction with ERP therapy as part of a wider treatment plan.

In addition to ERP and medication, you may find that support groups can offer some additional benefit for your symptoms. Support groups can help you connect with other people that are going through similar feelings, struggles, and experiences.

The International OCD Foundation also gives several tips on navigating treatment and managing your symptoms. Some steps may include:

  • Expect the unexpected. Old thoughts can resurface, and new ones can arise. This is all part of the process.
  • Acknowledge your thoughts, agree with them, and move on. These thoughts don’t have any true answers, after all.
  • Avoid trying to “not think” the thoughts. Trying to prevent or block thoughts can often have the opposite effect, leading to more intrusive thoughts.
  • Accept that slip-ups will happen. Even if you give in to a compulsion, there’s always a chance to interrupt it or to try again next time.
  • Try to handle your symptoms independently. Relying on other people may not help as much, because they might not always be available. You’ll always be available for yourself.
  • Move towards the anxiety. The way to overcome a fear is to face it. Working with a therapist can make this possible.
  • Follow your homework assignments. If your therapist gives you homework, try your best to follow along.

If you’re also living with other underlying conditions, such as arthritis, you can work with your primary care doctor to develop a treatment plan specific to your other condition. This may involve medications, therapies, and lifestyle changes.

If you’re dealing with symptoms of OCD and pain, you’re not alone.

If your pain is causing you additional distress, you can talk with your doctor about ways to manage it. Your doctor can help adjust therapies or medications to help you better cope with physical pain.

Consider joining a support group if you’re struggling with feelings of isolation. The International OCD Foundation offers a list of potential online and phone support groups you can check out.