Chronic Back Pain and Depression: Is There a Link?
This content was medically reviewed by Baher S. Yanni, MD, on February 15th, 2022.
Millions of people are living with chronic back pain that impacts their mood daily. Some studies show up to 23% of the world’s adult population experiences low back pain. It’s hard to feel upbeat and optimistic when debilitating chronic back pain is keeping you on the sidelines, leading to feelings of helplessness. Chronic back pain and depression seem to go hand-in-hand, and some have speculated that having one can lead to the other.
If you’re suffering from chronic back pain and finding it’s negatively impacting your mood and leading to feelings of helplessness, keep reading to learn more about possible links and options to help you cope.
Is There a Connection Between Back Pain and Depression?
Suffering from chronic back pain is certainly a reason to feel helpless. At times, your chronic back pain adversely impacts your emotional well-being, but the science behind the two conditions suggests it’s more than simply feeling down and out because you’re in pain. Many of the same neurotransmitters that regulate mood are also responsible for regulating pain in the body. In recent studies, neurologists have discovered links between chronic pain and depression in the brain.
Serotonin and norepinephrine are the two neurotransmitters that regulate both pain and feelings of happiness. When your body is in pain, brain pathways that handle the reception of pain signals use these two neurotransmitters to regulate pain and mood. When this regulation fails, your pain is intensified, but so are feelings of sadness, helplessness, anxiety and depression.
Similar to chronic pain, chronic depression can persist and alter the functioning of the nervous system. This phenomenon leads to bouts of chronic depression accompanying intense, debilitating chronic pain, which is more likely to perpetuate itself.
This makes sense as chronic pain has been proven to cause impaired cognitive ability and reduced grey matter in the brain. Similar studies have looked at a possible link between those suffering from chronic depression who also report experiencing a sudden onset of chronic pain.
Can Depression Cause Back Pain?
Issues such as anxiety and depression can also create chronic pain in patients who otherwise didn’t experience pain before. Depression and back pain together are a debilitating combination that can leave you feeling hopeless. Feelings of anxiety and depression can trigger body aches and pains that make it difficult to exercise and get the activity you need to live a happy, fulfilling life.
The lack of activity often leads to a weakening of the spine and the onset of chronic back pain, along with other issues associated with decreased physical exercise — such as obesity, high blood pressure and diabetes.
Depression and back pain tend to occur together, as those suffering from chronic depression may not have the motivation necessary to get the physical activity they need to stay healthy and keep their bodies functioning. It makes sense that patients experiencing depression also suffer from back pain and vice versa, but can the two be relieved together?
Let’s look at the ways back pain and depression are treated together.
Can Back Pain and Depression Be Relieved Together?
Physicians treating patients suffering from chronic back pain will often prescribe the same medications used by psychiatrists to treat anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) and tricyclics are both antidepressants typically reserved for treating patients suffering from depression and anxiety, but they can also treat patients with chronic back pain.
Many psychiatric drugs can also treat patients with chronic pain. As your symptoms of anxiety, depression and insomnia are treated with mood stabilizers, benzodiazepines and anticonvulsants, your pain may also be relieved. Better sleep and an improved mood are essential to a pain-free life. As your mental health improves, your chronic aches and pains can too.
Likewise, addressing and treating your chronic pain can also improve your mood and outlook on life. If the obstacles associated with chronic pain have been keeping you down, it’s much easier to address mental health issues and work on getting your mind right when your body is capable of handling the day’s basic tasks.
Coping With Back Pain and Depression
Living with back pain and depression together can definitely make it hard to get through your day. While there is no cure-all solution to instantly treat both conditions, you’ll be relieved to know you have options to help you cope, including:
- Physical therapy
- Cognitive-behavioral therapy
- Medications and antidepressants
Managing back pain and depression typically involves some combination of these solutions — and for some patients, all three options simultaneously. Let’s examine these three ways to treat and cope with both back pain and depression below:
1. Physical Therapy
There are two types of physical therapy used to treat patients suffering from debilitating chronic back pain — active and passive. Active physical therapy involves patients participating in stretching, low-impact exercises and a combination of the two. Passive physical therapy for chronic back pain involves the application of heating pads, ice packs or electrical stimulation to help relieve your pain. Many times, patients will participate in a combination of the two therapies for approximately four weeks.
Active physical therapy is a great option for those experiencing both depression and chronic back pain. Physical exercise releases endorphins that help you feel better physically and mentally. You may have heard the term “runner’s high” to describe the euphoria long-distance runners feel both during and after exercise. This euphoric feeling occurs from the release of endorphins that happens as you exert yourself physically.
2. Cognitive-Behavioral Therapy
This option is a little more complex than physical therapy and involves creating real changes in behaviors that lead to the onset of both anxiety or depression and back pain. These changes in behavior and thinking include avoiding stressful situations that can exacerbate your chronic pain. For example, if you’re easily stressed by discussing financial issues, you’ll want to avoid doing so just before bed. Putting yourself in a stressful state before bed can cause serious sleep disturbances.
You’ll want to develop ways to avoid triggers that cause stress. Whether it’s financial issues or the anxiety associated with running late for an appointment, you can manage your stress and the pain that accompanies it by changing your behaviors. Developing new methods to approach, manage or avoid stressful triggers is a great way to treat your depression and back pain simultaneously.
3. Medications and Antidepressants
The third option for coping with back pain and depression involves the prescription of medications and antidepressants. Medications such as muscle relaxers can relieve pain in the short term, allowing you to participate in your daily activities pain-free. Antidepressants such as SSRIs and tricyclics can also be effective in relieving your chronic back pain symptoms. Both types of antidepressants impact brain pathways responsible for regulating your mood and pain.
Discuss options like short-term pain relievers and antidepressants with your doctor. Not all patients suffering from back pain and depression are good candidates for one or the other, and your doctor will advise you on treatment options best suited to meet your unique needs.
Schedule an Appointment With Spine INA
Are you suffering from chronic back pain that has you feeling down, low or helpless? Don’t let the pain keep you on life’s sidelines, watching and hoping you get better.
With five convenient locations around central New Jersey, the staff at Spine INA is dedicated to finding the cause of your chronic back pain and helping you treat it and eliminate it from your life. Our team of doctors utilizes the least invasive spinal procedures with the most effective results.
We offer various treatment options designed to get you back to enjoying a pain-free life. Contact us online or call us at (609) 371-9100 to schedule an appointment with a spine specialist at Spine INA today!
Links used:
https://www.ncbi.nlm.nih.gov/books/NBK538173/
https://www.health.harvard.edu/mind-and-mood/depression-and-pain
https://spineina.com/blog/whats-causing-muscle-knots-in-your-back/
https://spineina.com/treatments/neuromodulation/spinal-cord-stimulation/
