Chronic pain and depression: understanding the connection and finding relief

Your mind and body are always talking to each other. When you're feeling calm, connected, and hopeful, your body often follows — sleep improves, tension eases, and even physical discomfort can feel more manageable. The same is true in reverse: challenging moods can make pain feel harder to cope with. This is especially in the case of chronic pain and depression — two conditions that are far more intertwined than most people realize.

Chronic pain and depression often go hand in hand. Research shows that about 40% of people with chronic pain also experience depression or anxiety. And 55% of people with anxiety or depression have chronic pain. The good news: because these conditions are so closely connected, treatments that help one can often help the other, too.

"Chronic pain and depression treatment often includes regular physical activity, as well as targeted exercises," says Matt Turner, PT, DPT, a physical therapist at Hinge Health.

Read on to learn more about how chronic pain and depression are connected, and what you can do to find relief, including targeted exercises recommended by Hinge Health physical therapists.

How chronic pain and depression are connected

Chronic pain and depression have what’s called a bidirectional relationship, meaning one affects the other. In other words, pain can affect your mood, and depression can make pain feel harder to manage.

"When you're in pain, you may find it hard to sleep and stay active, both of which impact your mood," says Dr. Turner. Activities that once felt easy or enjoyable may start to feel more difficult, which can lead to frustration, isolation, and may even lower your quality of life.

Depression can also affect how you experience pain. When you're feeling stressed, anxious, or depressed, your body may become more sensitive to pain signals. You may also notice increased muscle tension, lower energy levels, and changes in sleep, all of which can make pain feel harder to manage.

Over time, this can create a cycle where pain affects your mood and low mood makes pain more difficult to cope with. "Depression can also contribute to feelings of hopelessness, making it seem as though pain may be difficult to improve or manage," says Dr. Turner. The good news is that addressing either condition can often help improve the other.

Symptoms of chronic pain and depression

Chronic pain can affect more than your physical health; it can also shape your emotional well-being. Recognizing how pain influences your mood is an important step toward feeling better and finding the support you need. Signs that chronic pain may be affecting your mood include:

• Emotional symptoms. Persistent sadness, irritability, anxiety, hopelessness, or guilt about not being able to do the things you want to do.

• Physical symptoms. Increased pain sensitivity, fatigue that doesn't improve with rest, sleep problems, changes in appetite or weight, and ongoing muscle tension.

• Behavioral symptoms. Withdrawing from friends and family, losing interest in hobbies, avoiding physical activity, or struggling to keep up with daily routines. “You may find that you stop doing activities you usually enjoy, like seeing friends or exercising,” says Dr. Turner. “It's easy to feel disconnected, both from others and from yourself.”

The connection between pain and mood can build gradually, which makes it hard to recognize at first. “Check in with yourself regularly,” says Dr. Turner. “If you notice changes in your mood, energy, or daily habits, start moving your body to begin the process toward feeling better.”

How movement can help chronic pain and depression

When you're living with both chronic pain and depression, exercise may be the last thing you feel like doing. But research shows that movement is one of the most effective — and accessible — tools for managing both conditions.

Physical activity helps break the cycle that often develops between pain and mood. "When people are in pain, they tend to move less, withdraw from activities they enjoy, and spend more time focused on their symptoms," says Dr. Turner. "Movement helps interrupt that pattern."

At Hinge Health, physical therapists often say that movement is medicine. Exercise releases endorphins and other brain chemicals that support mood, while also reducing stress, easing muscle tension, improving sleep, and helping the nervous system become less sensitive to pain over time.

Targeted exercises can be especially helpful because they address the physical limitations that often accompany chronic pain. As strength, mobility, and confidence improve, everyday activities may start to feel easier. "When people see that they can move safely and successfully, it helps rebuild trust in their bodies," says Dr. Turner. "That confidence can be just as important as the physical improvements."

Together, these exercises can support both physical and emotional well-being. Standing child's pose, knee rocking, scapula clocks, back rotation stretches, and side bends promote gentle movement, reduce stiffness, and encourage relaxation. Squats help build the strength and confidence needed for everyday activities. Over time, moving more comfortably can make it easier to stay active, which is an important part of managing both chronic pain and depression.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips to manage chronic pain and depression

Living with chronic pain can affect nearly every aspect of your life, including your mood, energy levels, relationships, and confidence. The good news is that small, consistent actions can help break the cycle between pain and depression. Here’s what Hinge Health physical therapists recommend:

• Try physical therapy and targeted exercises. Targeted exercises, such as the ones above, can help reduce pain, improve function, and boost mood. “It empowers people to see that their bodies are resilient and capable of making meaningful progress,” says Dr. Turner. 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.

• Stay active. “Movement releases endorphins, which can improve mood, and it helps keep your joints moving and your muscles strong,” says Dr. Turner. If activity increases your symptoms, try adjusting the duration, intensity, or type of movement rather than stopping altogether. The goal is to keep moving in a way that feels manageable.

• Consider therapy or counseling. Cognitive behavioral therapy (CBT) and other forms of counseling can help you develop coping skills, manage stress, and reframe unhelpful thoughts about pain. “A therapist can validate that your pain is real and help you determine when it’s appropriate to push yourself and when it’s time to rest,” says Dr. Turner.

• Consider lifestyle modifications. Factors like sleep, stress, and nutrition can all play a role in both chronic pain and depression. “It’s a vicious cycle: when we are stressed from pain, we find it hard to sleep, eat right, and exercise, which are all important to stave off depression,” explains Dr. Turner. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

• Stay socially connected. Chronic pain and depression can both lead to isolation. Spending time with friends, family, support groups, or even connecting through a phone or video call can provide encouragement and help you feel less alone.

• 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 help reduce inflammation and offer nutrients that support tissue repair, such as omega-3 fatty acids and vitamins C and D. For individualized guidance, consider working with a registered dietitian.

• Consider over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have chronic pain. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments to manage both chronic pain and mood, such as massage, acupuncture, or chiropractic care. 

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce chronic pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

Five coping skills for chronic pain 

Managing chronic pain isn't just about reducing symptoms. It's also about building skills that help you navigate difficult days and stay engaged in the activities that matter most to you. Dr. Turner recommends focusing on these five areas:

• Acceptance. Acceptance doesn't mean giving up or resigning yourself to pain. It means acknowledging what you're experiencing without blaming yourself. “You didn't do anything to cause your pain, and it's not something to be ashamed of,” says Dr. Turner.

• Understanding. Learning about your condition can help reduce fear and uncertainty. Understanding how pain works — and what factors can influence it — often helps people feel more confident and in control.

• Coping. Chronic pain can be isolating. Connecting with friends, family, support groups, or others who understand what you're going through can provide validation, encouragement, and practical advice.

• Calming. Stress and anxiety can amplify pain. Techniques such as deep breathing, mindfulness, meditation, or gentle movement can help calm your nervous system and make symptoms feel more manageable.

• Balancing. Chronic pain shouldn't be the only thing that defines your day. Dr. Turner encourages people to make time for activities they enjoy, whether that's spending time with loved ones, pursuing hobbies, or engaging in gentle exercise. Finding moments of joy and meaning can help improve both mood and resilience.

When to see a doctor

If you’re living with chronic pain and/or depression, see a healthcare provider. It’s especially important to get prompt care if you’re experiencing any of the following:

• Sadness and anxiety that prevents you from functioning

• Irritability

• Loss of interest in hobbies and activities

• Trouble concentrating

• Sleep problems

• Changes in appetite

• Becoming withdrawn from others

• Thoughts of hurting yourself or others (seek immediate help right away — call or text 988, call 911, or go to the nearest emergency room)

PT tip: See flare-ups as information, not failure

Pain flare-ups are a normal part of living with chronic pain. Rather than judging yourself when they happen, look at them with curiosity. “Try to figure out what caused this most recent flare, so you can identify patterns and take steps to better manage them in the future,” says Dr. Turner.

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.

References

1. Aaron, R. V., Ravyts, S. G., Carnahan, N. D., Bhattiprolu, K., Harte, N., McCaulley, C. C., Vitalicia, L., Rogers, A. B., Wegener, S. T., & Dudeney, J. (2025). Prevalence of Depression and Anxiety Among Adults With Chronic Pain: A Systematic Review and Meta-Analysis. JAMA Network Open, 8(3), e250268. doi:10.1001/jamanetworkopen.2025.0268

2. Qiu, Y., Ma, Y., & Huang, X. (2022). Bidirectional Relationship Between Body Pain and Depressive Symptoms: A Pooled Analysis of Two National Aging Cohort Studies. Frontiers in Psychiatry, 13. doi:10.3389/fpsyt.2022.881779

3. Mental Health America. (2024, December 3). Chronic Pain and Mental Health | Mental Health America. Mental Health America. https://mhanational.org/resources/chronic-pain-and-mental-health/

4. Wu, P., Chen, X., Wang, S., Chen, X., & Liu, J. (2025). Effects of exercise on depression and anxiety in patients with chronic pain: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 389, 119630–119630. doi:10.1016/j.jad.2025.119630

5. Zgierska, A. E., Edwards, R. R., Barrett, B., Burzinski, C. A., Jamison, R. N., Nakamura, Y., Henningfield, M. F., Tuan, W.-J., Shen, C., Sehgal, N., Lennon, R. P., Dong, H., Chinchilli, V. M., Liu, Y., Turnquist, A., Schiefelbein, A. R., Jacobs, E. A., Veasley, C., Cowan, P., & Garland, E. L. (2025). Mindfulness vs Cognitive Behavioral Therapy for Chronic Low Back Pain Treated With Opioids: A Randomized Clinical Trial. JAMA Network Open, 8(4), e253204–e253204. doi:10.1001/jamanetworkopen.2025.3204

6. Depression. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/depression#part_6153