Back Pain and Depression
Healthcare professionals have been aware for a long time that people suffering with chronic pain especially of the back, are at a higher risk of developing depression. Research has also now shown that those suffering depression are also more at risk of developing a chronic pain condition. This starts a cycle of events that can spiral without treatment.

It is very common for sufferers of chronic back pain to develop depression, and it is the most frequently associated mental condition with the incidence of chronic back pain.

Signs and Symptoms

The symptoms of depression are inter-linked with those of back pain. Back pain can lead to a disturbed sleeping pattern meaning that mood can be negative during the day, along with fatigue. A lack of sleep and muscle fatigue increases the risk of injury.

Back pain can cause a reduction in mobility, so everyday activities and employment can be affected, leading to social isolation; depression is made worse by withdrawing from normal society and black moods can increase in frequency and duration.

Other symptoms that can appear with both conditions are feelings of being blue, lonely and a change in appetite. A reduction in nutrients will slow the recovery or healing process on the back injury.

Effects of Back Pain and Depression

Chronic back pain can affect an individual’s ability to work, this can lead to money worries which can cause or exacerbate symptoms of depression.

Sexual ability and function may be altered with the incidence of back pain; this could cause tension in relationships, as can a reduction in the participation in everyday family activities.

Research has shown a link between delayed healing after surgery in those who are suffering with depression. It is recommended that the depression is treated prior to surgery where possible. There is also valuable research that has shown a link between the incidence of depression and the likelihood of a back pain recurrence.

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Treatments

Sufferers of chronic back pain should be treated for the underlying cause of the pain if it can be found, with the doctor performing an evaluation of mental state at the same time.

Doctors are very aware of the analgesic effects of prescribing an anti-depressant medication for its pain relieving properties; in fact on occasion an anti-depressant will be prescribed for its analgesic benefits alone, even without the patient having any symptoms of depression.

The most common anti-depressant used for its pain relieving qualities is called Amitriptyline. It has been found that anti-depressant medication can be useful in the treatment of fibromyalgia, rheumatoid arthritis, osteoarthritis and cancer pain.

Other treatments that can help treat both chronic back pain and depression together can include massage, hypnotherapy and gentle exercise. Massage can help relieve stress, therefore lowering a risk factor of developing depression and also helping relieve the tension in muscles that can add to pain levels. Hypnotherapy can help the individual gain some control over their feelings and pain levels and may increase concentration and memory, both of which may be affected by depression and chronic pain. Exercise allows for social interaction and as a method of relieving pain. Sunshine and fresh air may also contribute to lifting the person’s mood.

Tasks should be broken down into more manageable jobs and should be completed in a realistic time frame; this allows for maintaining independence and helps with mobility issues.

Anyone who is feeling depressed should be aware of its link with the development of chronic pain conditions and sufferers of long-term back pain should be aware of the risks of suffering from depression.

Your GP will help you make decisions that are beneficial to you; this may include counselling to help with the management of pain in everyday life and to help cope with living with depression.