Can anxiety cause muscle spasms? Causes and tips

Anxiety isn’t just something you feel in your mind — it also shows up in your body. “When you’re anxious, your body’s fight-or-flight system switches on to help you deal with stress,” says Laura Plankis, PT, DPT, a physical therapist at Hinge Health certified in pain reprocessing therapy (PRT). “This response is what contributes to many physical symptoms of anxiety, including muscle tension, rapid heartbeat, and sweating.” 

Whether you’re stressed at work or feeling anxious, your sympathetic nervous system triggers the fight-or-flight response — preparing your body to face danger by contracting your muscles. In the past, this helped our ancestors get ready to run from a lion, for example. But when there’s no real threat, your muscles stay contracted and tense up, leading to muscle spasms or twitches. 

If anxiety or stress sticks around, muscle tension can start to affect how you feel day-to-day. Managing stress and anxiety levels by getting quality sleep, practicing relaxation techniques, and staying active can all help reduce muscle spasms that are related to anxiety.  

Learn more about the connection between anxiety and muscle spasms and ways to find relief, according to Hinge Health physical therapists. 

What are muscle spasms and twitching? 

A muscle spasm is a sudden, involuntary tightening or contraction of a muscle that can feel like an ache, tightness, or even an intense cramp. It usually lasts for a few seconds or minutes, but the ongoing sensation of muscle tightness or aching can persist for several days — depending on what’s causing the spasm and where. Muscle twitches also describe involuntary muscle tightening, but a twitch usually only lasts for a few seconds and can come and go. 

How anxiety and stress cause muscle spasms

Stress and anxiety — whether short-term, occasional, or a diagnosed anxiety disorder — can affect the connection between your body and mind. When you’re feeling anxious or under pressure, changes in your nervous system can trigger muscle contractions. Ongoing stress can leave your muscles tired and more prone to spasms. Here are some common ways stress and anxiety can lead to muscle spasms:

• Elevated adrenaline and cortisol levels. The nervous system has different parts that work together, including the sympathetic (“fight-or-flight”) and parasympathetic (“rest-and-digest”) systems. When you’re stressed or anxious, your sympathetic system kicks in and releases hormones like adrenaline and cortisol to help you manage the perceived threat (the thing that’s stressing you out). This is why your heart may race, your palms get sweaty, and your muscles tighten up. “When you’re under stress, your body may continue to release these hormones that cause your muscles to tense up,” says Dr. Plankis.

• Nervous system hyperactivity. Muscle contractions are common during stressful periods. When your brain senses a threat, it triggers your body to prepare for action — which can cause your muscles to tighten up or contract without you meaning for them to, says Dr. Plankis.

• Muscle fatigue from chronic stress. Just like the rest of your body, your muscles need time to rest and recover. Ongoing stress and poor sleep can leave your muscles feeling tired, which may lead to twitching or spasms. “When we’re fatigued, our muscles can react more easily and become overactive,” says Dr. Plankis.

• Electrolyte imbalances. Electrolytes like sodium, magnesium, and potassium — found in many fruits and vegetables — are important for healthy muscle function. Stress and anxiety can sometimes make you skip meals or choose convenience foods, which may mean you’re not getting enough of these key nutrients or staying hydrated. “If you’re busy or stressed, you might be compromising nutrition, which can indirectly lead to muscle twitching,” says Dr. Plankis.

Other symptoms of anxiety-related spasms

Anxiety can cause many different physical symptoms, including muscle twitching and spasms. You may also notice the following symptoms:

• Sudden twitching or trembling in muscles, especially in the face, hands, legs, or arms

• Acute muscle cramps

• Persistent muscle tightness or stiffness

• Muscle fatigue or weakness following spasm episodes 

Treatments for muscle spasms and twitching 

There are several ways to manage muscle spasms and twitching caused by anxiety or stress. Physical therapy and targeted exercises can help relieve muscle tension and improve flexibility, while relaxation techniques like deep breathing or yoga can calm both your mind and body. Other treatments include:

• Try physical therapy and targeted exercises. If you’re experiencing muscle tension in common places like your back and neck, for example, physical therapy and targeted exercises can help alleviate discomfort. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Practice relaxation techniques. Relaxing activities such as deep breathing (specifically, diaphragmatic breathing), meditation, or yoga can help calm your mind and, in turn, switch off the fight-or-flight hormones that contribute to physical symptoms like twitching and spasms. 

• Try cognitive behavioral therapy (CBT). CBT is a form of psychological therapy that has been shown to help reframe unhelpful thought patterns, promote relaxation, and reduce chronic pain. It’s one of the most common evidence-based interventions for anxiety. If you’re struggling with persistent anxiety, ask your provider to recommend a psychotherapist who practices CBT. 

• Focus on sleep hygiene. Adopting good sleep hygiene habits, such as stretching and powering down screens before bed, can all help improve sleep quality. Research shows that improving sleep can also provide multiple mental health benefits, such as reduced anxiety, depression, and stress. Getting enough sleep not only helps lower stress, but also allows your soft tissues to rest, repair, and heal.

• Prioritize nutrition. Eating a balanced, nutrient-rich diet supports your body’s natural healing processes. Focus on foods like fruits, vegetables, fatty fish, nuts, seeds, and whole grains. These foods offer nutrients that support electrolyte balance, such as potassium, magnesium, and chloride. For individualized guidance, consider working with a registered dietitian.

• Ask your provider about anti-anxiety medications. When anxiety is severe or interfering with your daily life — including causing physical symptoms like muscle spasms — your doctor may prescribe an anti-anxiety medication to reduce your symptoms. 

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for muscle spasms, such as massage, acupuncture, or chiropractic care.

How to prevent muscle spasms related to anxiety

If you’ve struggled with muscle spasms related to anxiety and want to take steps to prevent them from happening again, some simple lifestyle changes may help, like engaging in regular exercise and mindfulness practices can support your mental and muscular health. Try the following to reduce muscle spasms related to anxiety and stress: 

• Stay active. Regular physical activity is one of the best ways to help your body handle stress. “Gentle movement is a great way to help your body process stress, which decreases the effect anxiety has on your body,” says Dr. Plankis. Exercise also enables your brain to release the feel-good hormones dopamine, serotonin, and endorphins, which can ease anxiety and help reduce muscle tension. One study found that regular exercise significantly reduces anxiety symptoms and improves overall mood.

• Practice mindfulness. Mindfulness means being fully present and aware of your thoughts, feelings, and surroundings. It can help you feel calmer, reduce stress, and appreciate life more. Taking a mindful walk — where you take note of what you smell, hear, and see — can help you relax and ease tension in your body. Or, when journaling your thoughts and feelings, notice how your hand feels as it moves with the pen or pencil.

• Manage stress levels. Spending quality time with supportive people and making space for hobbies you enjoy — like journaling or your favorite physical activities — can help you manage stress, support your nervous system, and reduce muscle tension.

• Reduce the use of stimulants. While stimulants like caffeine and nicotine can give you a quick energy boost, they may also increase feelings of anxiety and muscle tension. Cutting back on these may help prevent anxiety-related symptoms and subsequent muscle twitching or spasms. 

When to see a doctor 

Anxiety and related muscle spasms or twitching often improve on their own with at-home treatments. But if your anxiety and related muscle twitching or spasms are severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Persistent or worsening spasms or twitches despite managing stress

• Symptoms accompanied by weakness or numbness

• Sudden onset without clear triggers

• Reduced quality of life 

• Distressing thoughts 

PT tip: Try movements that alternate sides

Any exercise can help manage anxiety and muscle spasms, but Dr. Plankis especially recommends reciprocal movements, or activities that involve moving one side of your body and then the other, like walking, swimming freestyle, marching in place, or lifting weights on alternating sides. These movements not only support healthy muscles, but they can also help calm anxiety by creating a natural, soothing rhythm in your body.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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