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Is Your Chronic Back Pain Linked to Depression?

Published July 28, 2017

If you are not feeling like yourself while living with chronic back pain, you are not alone. Period — end of sentence. Not only is your pain real, but your emotions are too.

According to the National Institute of Mental Health, “Depression is a recognized mental illness that is caused by a variety of genetic, physical, and environmental factors. Clinical depression goes beyond just feelings of sadness because of life circumstances.”

Depression interferes with your ability to enjoy life and is often accompanied by other eating and sleeping disorders. If plagued by depression, you may lack energy and the ability to concentrate on mundane tasks. So to add back pain to all of this — it's almost inconceivable.

According to Dr. Joseph Garbely, the chief medical officer of Friends Hospital in Philadelphia, Pennsylvania, "Depression is not a risk factor for everyone with back pain. But if you have severe or long-lasting back pain, then you might need to be concerned about your mental health as well. Major depression is thought to be four times greater in people with chronic back pain than the general population. Chronic back pain is the key here. Acute pain is not associated with depression, but chronic pain is.”

BackerNation is breaking it down so you can understand why the two go hand in hand. 

A study from the University of Sydney in Australia found an unquestionable relationship between back pain and depression. According to its results, individuals with depression are 60 percent more likely to develop back pain in their lifetime.

To reinforce this link, a new study was completed in 2015, published in Arthritis Care and Research that analyzed records from 11 international programs — a total of 23,109 people participated. The results “found not only that people suffering from depression are more likely to develop back issues, but the more severe the depression was, the likelier it was for the back issues to emerge.”

Dr. Paulo Ferreira, who conducted the study, explained, “Up to 61,200 of back pain cases in Australia alone can be partially attributed to depression. Back pain is a debilitating condition, particularly when coupled with other health conditions, so I hope this discovery [of linking the two together] will lead to better treatment in the future.

“We would have much better outcomes if we treated depression and back pain simultaneously, but this would require health professionals from different fields to work together more closely.”

It's very important to understand that having back pain doesn't automatically mean you will be depressed just as being depressed doesn't mean you will receive a back pain diagnosis, but the link between the two is evident — the question remains as to why the two are so closely linked.

Experts of back pain and depression acknowledge the fact that they cannot account for genetic and environmental factors that may be contributing to both ailments.

“While this study tells us there is definitely a link between depression and back pain, it doesn’t tell us why,” said Marina Pinheiro, a Ph.D. professor in the Faculty of Health Sciences at the University of Sydney who worked closely on the study with Dr. Paulo Ferreira.

“It could be because people with depression often have lower levels of physical activity and poor sleep, or due to issues with neurotransmitters which impact both mood and pain thresholds.”

If you catch yourself asking, “Why am I just so depressed right now” while living in chronic back pain — the experts continue to examine and ask the exact same question.

Understanding Why

Dr. Lindsey Marcellin, the medical team leader for Solar Light for Africa, LTD., a non-profit group providing solar energy systems to health care facilities in Africa, has led three medical assistance teams to Uganda explained, “At first glance, it might seem strange that a physical problem like chronic back pain and a mental problem like depression are so strongly linked. But when you look a little closer, it starts to make sense. The symptoms of back pain can cause a slippery slope that leads to depression.”

Causes Include:

  • Lack of sleepPeople with chronic back pain tend to not get enough sleep. If you become sleep-deprived for long periods of time, eventually it's going to affect your mood and emotions — leading to major depression.
  • Decreased movement — Living with chronic back pain is uncomfortable — plain and simple. Because you aren't feeling your best, you may move or exercise less than you would if you felt great. A lack of movement from either staying indoors or not walking outside may contribute to your decreased mood levels
  • Lessened social interactions — Your back pain may cause you to withdraw from social settings with friends and family. By withdrawing, you may not realize that it's adding your feelings of isolation and hopelessness.
  • Your pain medication may also lead to depression.

Dr. Garbely added, “Many medications prescribed for pain 'have a dulling or depressive effect'. The medicine also affects your memory and concentration, all symptoms of depression. Both sides of the cycle (pain and depression) have been looked at independently of one another, and studies have concluded that each can cause the other.”

In many cases, chronic back pain prevents people from doing the things that they love. In some cases, it prevents people from completing normal, daily activities.

If you suffer from chronic back pain, you understand the feeling of missing out on life. It almost feels like you’re being forced to sit down and watch your life pass by directly around you. This is a normal feeling and most people who suffer from chronic back pain experience this side effect. If you are feeling depressed, don’t lose hope.

Most cases of depression associated with chronic back pain are considered situational depression. Situational depression essentially means that there is nothing chemically altered in the brain to cause the depression, but that the situations in life have caused an individual to experience depression.

For many people, the inability to move and live without pain can cause depression. It is important to note that this depression is temporary and will be alleviated when a treatment is found for chronic back pain. If you are experiencing this type of depression due to lack of activity and feeling a loss of purpose due to chronic back pain, it is important that you seek a physician.

Your physician can help counsel you through your depression and find a treatment option for your back to help alleviate your pain and get you back to living your life. You should also consult your physician about any pain medication you take for your back pain because it’s just as important for your physician to know if you are experiencing any side effects so they can be addressed and modified to your benefit.

Treatment Options for Chronic Back Pain and Your Depression

If you are suffering from depression and chronic back pain, we are here to help you find relief and reclaim your quality of life. Our community truly cares about your quality of life because guess what — we are on your level. We are people with back pain trying to educate and enlighten others just like you with the same back pain.

What’s rather interesting about back pain and depression is that they seem to be so closely tied that getting depression relief may actually lead to back pain relief.

Dr. Garbely advised, “Treat both your depression symptoms and chronic pain symptoms with the help of an expert. Depressed mood will increase the perception of pain, so it actually intensifies the pain itself. So if you treat depression, pain is improved. To do this, see your doctor to determine if therapy or medication might be appropriate for treating your depression.”

On the contrary, receiving relief from your chronic back pain may also aid in treating depression.

To relieve your back pain, consider asking your doctor to recommend a physical therapist or a specific stretching and strengthening program.

“If movement is very physically difficult for you because of the pain, seek some help. Try physical therapy or non-pharmacological ways of alleviating the pain first. Of course, in some cases, surgery or more extensive medical procedures may be necessary, but this is generally the first course of treatment for back pain,” concluded Dr. Garbely.

If you aren't sure whether or not your back pain is the cause of your depression, talk to your doctor. Whatever the cause for your depression and your back pain, try to get comfortable talking about it.

Updated: February 12, 2020

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.

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