Aug 19, 2021
Pain & Injury

Is Your Lower Back or Hip Pain From Stress and Anxiety?

Is Your Lower Back or Hip Pain From Stress and Anxiety?

We face stressors in our everyday lives, from work to relationships, and it’s natural to accumulate stress and experience some anxiety. It’s how we harbor those emotions that can directly impact our health.

Did you know that stress, trauma, and emotions can cause muscle pain? For some, this pain becomes chronic until it is addressed both physically and mentally.

The more stress we hold on to, or the more trauma we suppress, the more our body works to overcompensate and protect us. Much of our stresses and emotional trauma are stored within our muscles like the hip flexors and neck.

Getting to know how stress impacts your anatomy can help you navigate your daily stressors and begin to manage your emotions with a more holistic approach.

Understanding hip pain from stress and anxiety

The bodily reaction to stress is a very primal one: it goes back to our instinctual response when we are in danger — our fight or flight response.

Stress and anxiety both evoke a very similar reaction to primal physical danger, especially in the hip flexors, which are designed to help us flee from a predator or dangerous situation.

When our brains are introduced to even minor stress, like running a few minutes behind in the morning, our body still causes pain and tightness within our muscles to keep us safe. Whether our stress is related to the hip or not, it could contribute to tension in the iliopsoas or hip flexor muscles.

Anatomy of stress and emotions

Just as all of our stresses will be different, where we hold tension tends to vary from person to person. However, the most common stress-related muscle tension patterns occur in the neck or hip muscles.  

This is mainly due to the fact that many of our most essential organs are directly next to the iliacus muscle in the pelvis. The pelvic area not only experiences physical and sexual trauma, but due to its location close to the reproductive system, it’s a common place for holding tension related to relationships and our sense of survival and safety.

Our digestive, urinary, and reproductive systems, as well as major lymph, nerves, and blood vessels, are in this area. This makes the iliacus muscle vital in protecting this area of our bodies. Similarly, the neck muscles serve the vital purpose of supporting and protecting our spinal cord and brain.

Fight or flight response

The way our body manages stress is a balance between our sympathetic nervous system (fight or flight) and our parasympathetic nervous system (rest and digest). A significant part of our sympathetic nervous system travels along the psoas, another strong connection between the iliopsoas and our stress response.

The vagus nerve is a main component of the parasympathetic nervous system. The vagus nerve travels throughout our diaphragm and affects our breathing. A strong indicator that our bodies are resilient to stress is that our vagus nerve is able to regulate heart rate variability: the ability of your body to speed up the heart when increased blood flow is needed and to relax again once that need diminishes.

When your diaphragm doesn't allow you to take deep breaths, your vagus nerve isn’t stimulated properly. Since the vagus nerve is a part of the rest-and-digest response of the parasympathetic nervous system, when we take deep breaths into our abdomen, it helps us shift from fight-or-flight to rest-and-digest.

The ability to breathe into your abdomen and not just your chest relates in part to the diaphragm's alignment, which is also impacted by tension in the iliopsoas muscles.

These physical reactions in the sympathetic and parasympathetic nervous systems do not just occur when we experience a moment of stress, though. As humans, we have a unique ability to evoke emotions from our memories as well.

If we had a traumatic experience that made a mark in our memory, when we think of that experience, our body will react just as it did the first time. Trauma and traumatic memories affect the brain’s sense of safety as we move through life, and can keep our muscles tense for years.

Managing stress, trauma, and emotion-related pain

The easiest way for us to approach muscle tension is to only look at the muscles that are tight. However, to fully address our whole body health, we should also look at our mental health and how it’s causing muscle tightness.

Below are four approaches that anyone can start when learning how to manage personal stressors, traumas, and emotions that cause muscle pain.


Muscle tension and muscle knots are caused by specific muscles being overused and holding onto stress. Muscle knots themselves are essentially muscles that never stopped contracting and haven’t been able to fully relax.

For muscles to be healthy, they need a break from contracting. When your muscles contract too much, your brain can’t turn off that contraction, making the muscle knot worse and worse. This can be just a small or large part of your muscle, and in some cases the whole muscle.

Whatever the cause, massage is one of the most direct and effective ways to release muscle knots. This can be done with a professional massage therapist, which is recommended since they will be attuned and responsive to the unique tension-holding patterns of your body. Otherwise, massage chairs and massage tools can also be used.

When you are getting a massage and working out muscle knots, it is important to note that it can evoke an emotional response, especially if the muscle tension comes from stress or emotional trauma. Recognize that a massage is a physical treatment, but mental therapies should not be ignored either.

Muscle release

In the same vein as massage, muscle release can help relieve muscle tension. The main difference between massage and muscle release is that muscle release tends to be more targeted to one specific muscle group, and involves direct pressure for an extended period.

One of the most effective areas to release muscle tension when managing stress is your iliopsoas. Both the iliacus and psoas muscles should be addressed when releasing the hip flexors.

The most standard at-home massage tools won’t reach either muscle, so many patients end up getting muscle release at physical therapy. This limits how effective the practice is, though, because most of us don’t go to physical therapy more than once a week.

If you want to integrate muscle release into your daily health routine, having tools like the Hip Hook and Hip Release Ball are the best way to go.

Designed by a physical therapist, the Hip Hook is the only muscle release tool that is designed specifically to release both the psoas and iliacus muscles. These muscles require a specific angular pressure along the pelvic bone that previously could only be accessed by a trained practitioner’s hands.

Since the iliacus isn’t the only muscle that makes up the hip flexors, you shouldn’t ignore the psoas either. This muscle is a bit easier to find but equally as challenging to reach. The Hip Release Ball is the right size and density to provide an effective muscle release without getting lost in your abdomen.

anatomy illustration of the psoas and iliacus muscles

Breath and meditation

As mentioned before, the diaphragm muscle is responsible for your breathing, and directly impacts your ability to release your body from the fight or flight response.

When your diaphragm contracts, it pulls air into the lungs by opening the chest cavity and creating less space in the abdomen. That’s why when you take a deep breath, you feel your stomach expand and deflate along with your chest.

If you only breathe in your chest cavity and do not include the abdomen, your breath does not facilitate relaxation, and you get less oxygen. This means that if you are continually taking shallow breaths, your stress level will increase, not decrease.

Your stress levels are correlated with your frequency of abdominal breathing, and the tightness of your iliopsoas. The psoas muscle is attached to all the lower lumbar spinal vertebrae all the way up to the connection at the rib cage. So, a tight psoas makes for a tight diaphragm and less breath control.

This is clear anatomically when you think about the connective tissues surrounding the iliacus and the pelvic bowl that run up the back of the spine to the psoas and into the diaphragm. All of these muscles' interconnected nature makes a big “C” shape and restricts the diaphragm movement when any of them are too tight.

As you work to release tight muscles, adding breathing exercises, and meditation into your routine will become equally important. After all, slow, deep breathing is an immediate way to relax your body and abdominal muscles specifically. This turns off your fight or flight response.

As you take deep breaths into our abdomen, your body begins to regain a sense of balance and tranquility. The fight or flight response your stress has been evoking will start to diminish with each breath.

An easy way to start practicing mindful breathing each day is to take three deep breaths when you begin to feel overwhelmed or stressed. It’s simple and extremely powerful: just stopping to take three deep breaths can change how your nervous system is responding to the moment.

Beyond that, if you actively manage anxiety or overcome emotional traumas, consider setting a timer for once every hour. When the timer goes off, stop what you are doing, close your eyes, and take three deep breaths into your abdomen. To ensure you breathe through your abdomen and not just your chest, put one hand on your stomach and one on your chest as a warm, gentle reminder and feel them rising and falling.


The final recommendation for managing stress and hip pain is to go to therapy. Yes, working through emotional traumas is just as important as releasing your muscles. After all, once you control your anxiety and emotions, the way your body is reacting to everything throughout the day will change.

Talking to a professional can give you a launching pad to integrate more mindful habits into your routine and manage stress daily. As you get to know the deeper, darker parts of yourself, you will be prepared as your body reacts to past traumas and emotional triggers.

There is still some stigma surrounding the need for therapy in everyone’s life. However, you don’t have to have depression or anxiety to benefit from seeing a therapist. Most people find benefit in a new perspective, someone to talk through little struggles, and to have someone who is trained in psychology help give them tools to approach stressors.

Managing pain from stress and anxiety

Everyone reading this has likely experienced one stressful situation already today. If left unchecked, these little daily stressors – our human affinity for anxiety, and harboring past emotional traumas – can cause deep hip pain and even lower back pain from stress.

We often associate anxiety pain with chest pain, which also occurs, but the diaphragm muscles connect to the iliopsoas. All of our muscles tightening to protect us is a natural reaction, but our daily life will become much harder if we try to “muscle through” (literally) with unresolved tension.

Finding time to slow down, take a few deep abdominal breaths, and work other stress management techniques into your daily routine can help give your muscles a much-needed break, and help you relieve some stress.

Frequently asked questions about stress and muscle tension

Can stress and anxiety cause body aches?

Absolutely. Our bodies respond to our thoughts, whether we’re remembering past experiences or responding to the present moment. We tighten muscles in a primal response to stress, or to protect certain areas of the body from trauma. While this is a natural healthy response, it becomes problematic when those muscles don’t let go and instead create chronic tension and pain.

Can you carry stress in your hips?

Your iliopsoas muscles have connection points to the top of your ribs, all along your lower spine, pelvic bowl, and to the top of your femur (thigh bone). A tight iliopsoas can be both the cause and the result of an inability to take a deep breath due to misalignment of the diaphragm and/or a result of the connection between the vagus nerve (a major component of the parasympathetic nervous system) and the psoas.

Are emotions stored in the hips?

Our bodies respond to our thoughts, whether past or present. The iliopsoas muscles run alongside multiple organs as well as the female reproductive system. These muscles can tighten as a result of stress, trauma, thoughts, memories and experiences, and then have difficulty releasing. Tension on the iliopsoas can also affect the functioning of the diaphragm, the ability to take deep breaths, and turning off the body’s stress response.