Studies have concluded that the more severe back pain a person has, the more likely they are to experience depressive symptoms – so you’re not alone if you feel like your back problems are keeping you down in more ways than one.
While chronic back pain can cause depression, depression can also cause back pain.
In fact, body aches (including backaches) are a common symptom of depression, and research has shown that people with severe depression actually feel pain more intensely than others. Some studies have suggested that depression causes increased pain and inflammation via proteins known as cytokines, which are known to affect immune system responses to infection and disease and appear to be present in higher levels in depressed patients.
Moreover, not unlike chronic pain, depression itself can cause the kind of fatigue that prevents you from exercising and strengthening your core muscles, which in turn puts added stresses on the disks, joints and ligaments in your back, making you more susceptible to low back pain, muscle strains and other injuries.
So when we say that depression can actually cause back pain, we don’t mean that the pain is all in a patient’s head. We mean that the chemical processes and physical effects associated with clinical depression can contribute to the presence and/or severity of a person’s very real back pain.
Research indicates that depression, anxiety, negative thought patterns and even certain personality traits can have a negative effect on patient outcomes following spine surgery. This is believed to be due to the impact that such psychological factors have on motivation, sleep quality, adherence to a physical rehabilitation program and the ability to perceive improvements – all of which play a role in the healing process. So it’s important to talk to your doctor about depression signs and symptoms that you may have noticed in addition to your back pain. These include feelings of sadness, hopelessness, irritability, and overwhelming fatigue, along with sleeping problems, difficulty concentrating, loss of appetite, overeating or thoughts of death and suicide.
Treating patients with chronic back pain and depression requires a comprehensive approach.
Depressed patients who seek treatment for chronic back pain usually think of their condition in terms of “If I can just get rid of this pain, I’ll feel fine again,” – and to some extent, they may be right. However, when you understand how thoroughly pain and depression are interrelated, it makes sense to treat both conditions as part of your overall plan of care. That’s particularly true of patients who may be considering spine surgery, in order to give them the greatest potential for optimal post-operative results and rehabilitation.
Treatments for spine patients who display signs of depression may include psychological counseling, relaxation training and behavioral therapy, as well as the use of low-dose antidepressants. Such medications can reduce depressive symptoms as well as back pain because of the way they work to inhibit the reuptake of neurotransmitters within the brain (serotonin and norepinephrine) that are associated with a person’s mood and pain perceptions.
Another key to treating depression and low back pain is regular aerobic exercise, which stimulates serotonin levels in the brain and spurs the release of feel-good endorphins to relieve both depression and pain. While you should always check with your doctor prior to beginning a new exercise program, the benefits that proper exercise offers in terms of reducing stiffness and pain, strengthening core and back muscles, improving flexibility and boosting a person’s mood and self-esteem are indisputable.
Finding Depression and Back Pain Relief (01/14/2011). Retrieved from EverydayHealth.com: http://www.everydayhealth.com/depression/finding-depression-and-back-pain-relief.aspx
Depression and Chronic Pain (n.d.). Retrieved from National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/depression-and-chronic-pain/index.shtml
Depression Can Lead to Chronic Back Pain (n.d.). Retrieved from Spine-Health.com: http://www.spine-health.com/conditions/depression/depression-can-lead-chronic-back-pain
Depression (major depressive disorder): Is there a link between pain and depression? Can depression cause physical pain? (n.d.). Retrieved from MayoClinic.org: http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/pain-and-depression/faq-20057823
Chronic Pain (n.d.). Retrieved from Anxiety and Depression Association of America: http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain
The Link Between Depression and Physical Symptoms (2004). Retrieved from the U.S. National Library of Medicine/National Institutes of Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/