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Stress Can Hurt – Stress and Musculoskeletal Pain

By Rafael Bucater
from RAFA

Stress is a response to challenging or new life events such as a job loss, exams, deadlines, finances, or divorce. While stress is not a diagnosis, persistent stress can lead to long term physical and psychological symptoms.

It is estimated that more than half of Australians (59%) experienced at least one personal stressor in the last 12 months. The General Social Survey (GSS) found that during 2020, people with a mental health condition were more likely to have experienced at least one personal stressor compared to those who do not have a mental health condition (83% and 56% respectively).

Stress is a genuine issue. It can cause:

  • Tension, headaches, pain, and fatigue.
  • Digestive issues and stomach problems.
  • Anxiety, irritability, and anger.
  • A lack of focus and motivation.
  • Depression.
  • Eating disorders.
  • Substance abuse.
  • Sleep disorders.

The Perceived Stress Scale (PSS)

Developed in the early 1980s, it’s a measure of the degree of stress a person feels about their life. The questions in the PSS ask about feelings and thoughts during the last month. In each case, respondents are asked how often they felt a certain way. You can take a test here (

Stress and Musculoskeletal pain

Muscular co-contraction can also be related to pathological situations to states of physical or mental stress, or simply to the inability to relax. Physiologically, there is evidence that stress releases hormones like cortisol, which increase the pain perception and cause muscle tension. States of psychological stress can lead to prolonged contraction of trapezoid muscles, in severe cases, stress can be somatised as continuous states of muscular contraction of the shoulders and can lead to development of several chronic musculoskeletal pathologies (e.g., shoulder pain, headache).

Nordic musculoskeletal questionnaire

It consists of structured, forced, multiple choice questions and can be used as a self-administered questionnaire or as an interview. The original version consists of several parts: a general questionnaire, and three specific parts focusing on the lower back, shoulders, and neck. The questionnaire was designed to answer the following question: “Do musculoskeletal troubles occur in a given population, and if so, in what parts of the body are they localised?” You can answer the questionnaire here (

Stress management strategies and muscular pain releases.

Accordingly with the American heart foundation the 3 tips to manage stress:

  • Positive self-talk (I have got this)
  • Emergency stress-stoppers (Take deep breaths, going for walk)
  • Stress busting activities (take a walk, play with kids, exercise)

Top 3 shoulder stress relievers:

1 – Remedial massage

2 – Good posture

3 – Neck and shoulder stretches

Check out Rafael’s awesome video explaining Massage, Posture and Stretching

Remedial massage is a type of massage therapy that aims to treat specific musculoskeletal problems and restore normal function and movement. It can help with stress and muscle tightness by improving blood circulation, reducing inflammation, releasing trigger points, and relaxing tense muscles.

Remedial massage can also promote mental and emotional well-being by stimulating the release of endorphins, the natural painkillers and mood enhancers of the body.

Here are 2 great neck and shoulder stretches to do regularly to help reduce tight muscles from stress!


More about the author

Rafael Bucater

As a Massage & Exercise Specialist, Rafael uses a systematic process to functionally assess, correct and strengthen your body to function at its optimal level, and is passionate about teaching others to do so.

Rafael has been a Health and Fitness Professional since 2004 and has a wealth of experience applying rehabilitation skills to a variety of sports injuries, chronic pain, muscle disorders, joint aches and pre & post-surgery conditions.

Rafael has a bachelor’s degree in physical education, a post-graduate degree in exercise physiology overseas, and a diploma in fitness, sports, and remedial massage, in Australia.

Rafael currently lecturing at the Australian Institute of Fitness, Adelaide campus in fitness and massage courses for the last 7 years.

Rafael Bucater has presented at the 2019 South Australian Sports Medicine FAST conference to sports trainers on sports massage techniques and self-care techniques and offers mentoring services and tutorials to new therapists. He was also a finalist for the ATMS Natural Medicine Awards for Practitioner of the Year 2022!