***This content comes from the Joint Pain Programme Journal by Nuffield Health. As a Rehab Specialist running this program, I’m excited to share these helpful insights with you all.

Research shows that mood changes are very common when experiencing chronic joint pain and related conditions.

Many people experience stress or anxiety or can become fearful or restless in response to chronic joint pain. This is a normal and understandable response.

Anxiety and fear can stop people from engaging in healthy behaviors which promote well-being such as becoming more active or connecting socially.

Symptoms of Anxiety

Anxiety can be triggered when we are dealing with difficult situations, and managing joint pain presents many challenges.

Most commonly, anxiety is experienced in response to changes in heart rate or breathing faster, often alongside worry.

Common symptoms include:

Behaviors

• You may find yourself avoiding situations you associate with anxiety, preferring to ‘hide away’.

• You may find yourself seeking reassurance more from others and doing things that make you feel ‘safe’.

Thoughts

• Anxiety often presents with negative thought processes such as ‘Something bad is going to happen’.

• You may think there is something really wrong with you or that you’ll make a fool of yourself.

Physical Symptoms

• You may experience restlessness, a racing heartbeat, perspiration, nausea, shakiness, rapid breathing, dizziness, and more frequent visits to the toilet.

Emotions

• You may feel worry, dread, fear, panic, or embarrassment more easily and often.

Anxiety and Joint Pain

Changes in heart rate (beats) and breathing are common when you have anxiety.

These physical changes can be stressful and frustrating.

Sometimes they can lead to feeling fearful or panicky and can trigger something called the fight or flight response.

This is explained in more detail in the Understanding stress

After a period of ill health, you are also more likely to focus on body sensations and anxious thoughts relating to your health.

Focusing on body sensations can cause you to develop a heightened awareness of any body changes, including perfectly natural changes such as your heart rate increasing when you are more active.

These anxious thoughts can develop into unhelpful cycles that increase anxiety and can even lead to panic attacks.

It is also very easy to mistake anxiety or panic symptoms as signs of serious ill health, such as thinking you are having a cardiac event, which makes you feel even more anxious and locks you into unhelpful cycles.

How Can I Tell if I’m Experiencing Panic?

• Intense fear and anxiety that usually comes on fairly suddenly but goes down after a short time.

• Strong thoughts that something bad is about to happen, accompanied by physical symptoms such as:

  • Increased heart rate

  • Perspiration

  • Shakiness

  • Lightheadedness

The 4 Corners model can help you to understand the mind-body-mood connection and how anxiety can become a vicious cycle.

Practicing breathing techniques, managing your stressful thoughts, and relaxation can help with managing anxiety and breaking any unhelpful patterns.

Helpful Thoughts to Combat Anxiety

Getting caught up in unhelpful thinking patterns can increase anxiety.

It may be useful to try some helpful thoughts.

Here are a few suggestions you could try:

• This difficult time will pass.

• Even though I feel anxious, I can cope.

• Anxiety symptoms are unpleasant but not dangerous.

• Nothing awful is going to happen.

• I’m going to be okay.

Your Space to Reflect

📍 Starting Point

- What mood changes do you notice most with your joint pain?

- How do physical symptoms affect your emotional state?

🤔 Looking Deeper

- When do you notice anxiety or fear affecting your activities?

- How does your mood influence your pain management?

💡 Exploring Possibilities

- Which strategies help you manage difficult emotions?

- What activities help break unhelpful mood cycles?

🔄 New Perspectives

- How might accepting mood changes as normal affect how you handle them?

- What would responding to mood changes compassionately look like?