This review paper included 28 studies involving 39,166 participants and concluded that there is a strong relationship between stress and chronic nonspecific neck-arm pain (NSNAP).
“… according to the qualitative analysis there is a strong relationship between anxiety and chronic NSNAP.”
However, the chicken or the egg question remains: were those with pre-existing stress more likely to develop neck pain? Or did the chronic neck pain result in increased stress?
The likely answer is both! So what can we do as PTs? We must make every effort to not add further to their stress levels by reassuring and focusing on function. Some may of course benefit from cognitive behavioural therapy (CBT) and psychotherapy.
Reference: Ortego G et al Is there a relationship between psychological stress or anxiety and chronic nonspecific neck-arm pain in adults? A systematic review and meta-analysis. J Psychosom Res. 2016 Nov;90:70-81.