Chronic Back Pain And Depression

Depression & Chronic Pain: Symptoms & How To Treat It

Feb 14, 2018 | Patient

A lot of people with chronic pain report feeling depressed. For many people, its a chicken or the egg scenario. For instance, did I start feeling depressed or anxious because of my chronic pain? or is my back pain a physical manifestation of my depression?. Regardless of how your back pain and depression came to be, what often goes unspoken is the known link between depression and back pain. Pain and depression are positively interconnected.

People with depression are much more likely to experience back pain and people with back pain are more likely to be depressed. People with depression also feel pain more intensely than others. As such, back pain and depression can feel like a vicious cycle where depression is both a symptom and cause of back pain.

Read on as we break down depression and chronic back pain. We will answer what is depression?, share back pain and depression symptoms, explain how back pain and depression are connected, and share how you can work through these physical and mental setbacks.

How Can Physical Activity Help

Many people with chronic pain avoid exercise. But you can get out of shape and have more risk of injury and more pain. Talk with your doctor to design an exercise plan that’s safe and effective for you.

Trips to the gym also help ease depression by releasing the same kind of brain chemicals that antidepressant medications are thought to affect.

Depression And Back Pain/ Chronic Pain

Generally, when it comes to depression and back pain, the types of depression associated are major depression or clinical depression. Depression is associated with chronic back pain and lower back pain . As discussed above, chronic back pain is both a symptom of depression and a cause. This means that the two are interconnected and one can kickstart the other into action.

Experiencing mostly just lower back pain? Learn about the symptoms, treatments, and what to look out for.

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How To Cope With Chronic Back Pain And Depression

Chronic back pain lasts for more than three months. Unfortunately, it can prevent you from completing everyday tasks and leading the happy, fulfilling life you deserve. Therefore, it’s no surprise that chronic back pain and depression go hand-in-hand. In fact, research has shown that depression and anxiety affects 30 to 50% of individuals with chronic back pain.

In most cases, depression can intensify chronic pain and chronic back pain can magnify depression. People with chronic back pain are three times more likely to face symptoms of depression while those with depression are three times as likely to experience chronic back pain.

Back Pain Depression Link Found In Our Genes

Genetics are behind the link between lower back pain and depression, according to a pair of studies recently conducted by the University of Sydney and Spains Murcia Twin Registry and published by the International Association for the Study of Pain. Their studies are the first to examine the true relationship between lower back pain and depression.

Researchers looked at data from the well-established Murcia Twin Registry, which includes about 2,150 Spanish twins. These twin studies offer a unique chance to explain the link between health conditions, simply by eliminating the genetic and environmental factors that led to the conditions in the first place.

Responses to questionnaires helped to determine whether participants with symptoms of depression experienced more back pain. What they found was a clear link between the two. Upon further analysis of what are called monozygotic twins those who are genetically identical the association between lower back pain and depression completely disappeared, however.

In the past, studies revealed a consistent relationship between back pain and depression a combination that may complicate diagnosis and treatment.

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Clustering And Classification Validation

Step 8: Feature ranking and clustering was completed in training set then applied to the test data set. Similar feature weight and clustering performances were observed across training and test data sets . The Silhouette value for the training and test sets were 0.65 and 0.63, respectively . The within-cluster distances ranged from 0.054 to 0.217 in the training data and 0.054 to 0.243 in the test data . The between cluster distances ranged from 0.200 to 0.699 in the training data and 0.200 to 0.716 in the test data . The discrimination values ranged from 0.29 to 1.16 in the training data clusters and 0.29 to 1.14 in the test set clusters .

For classification, the classification accuracy for the validation set for SVM, Naïve Bayes, kNN and RF classifiers were> 99% , 63.6% , 92.3% and> 99% , respectively . For the test data the results SVM, Naïve Bayes, kNN and RF classifiers were 97.9% , 62.9% , 89.9% and 98.4% . Outside of Naïve Bayes classification, this shows similar clustering a classification results to the main analyses . Calibration curves are reported in Supplementary Figures and calibration metrics are reported in Supplementary Table .

Symptoms Of Chronic Pain & Depression

As mentioned previously, chronic back pain is any back pain that lingers for a period of three months or more. This pain may range in severity depending on the individuals case. Additionally, there are many other medical problems that may lead to chronic pain aside from depression. These causes of lower back pain can be difficult to pinpoint. Over time, chronic pain often gets worse as the body becomes more sensitive to it. This alters a persons pain perception and they may start to hurt in places that were previously fine.

One of the main concerns with chronic pain is that it snowballs in severity over a period of time. For example, chronic back pain may disrupt sleep, which may lead to a loss of productivity and decreased daily function. If this goes on for long enough, then a person will become irritable and have trouble socializing with others. It may make life seem too challenging and instill feelings of worthlessness.

Depression is extremely complicated, often misunderstood, and hard to treat. The main reason why depression can be so difficult to resolve comes from the fact that the average person does not seek professional help soon enough. In fact, it is most common for a person to suffer from depression for 10 years before seeking help for their condition. If you have the following symptoms, you may need professional guidance:

• Constant feelings of worthlessness or despair
• Suicidal ideation

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Back Pain And Depression

The Spine Health Institute observed that although back pain can lead to depression, depression can also cause back pain. Body aches are a common symptom of depression. Like those with anxiety, people with severe depression feel pain more intensely than those without. Some believe that depression can cause increased pain and inflammation.

Depression can also cause fatigue that can prevent those who have it from exercising. The lack of exercise can put added stress on the discs and joints in their backs, making them more susceptible to low back pain, injuries, and muscle strains.

The chemical processes and physical effects connected with clinical depression can add to the presence and severity of a persons back pain. From this standpoint, depression can also trigger back pain. William Deardorff, Ph.D., discusses at length the relationship between depression and chronic back pain.

Low Back Pain And Depression

Table 5 presents the unadjusted OR and 95% CI for the association between low back pain and depressive symptoms. The mean ± SD score for the Modified Zung Depression Index was 19.14 ± 9.796. The analyses demonstrate that people in the at-risk category of depression were more likely than people in the normal depression category to be classified as having low back pain. Significant associations were observed for the at-risk depression category and grades 2 and 3 low back pain, whereby individuals in the at-risk depression category were 2.002 times more likely classified with grade 2 and 1.874 time more likely to be classified with grade 3 low back pain than those in the normal depression category. Non-significant direct associations were seen between the depressive category of depression and grade 2 and 3 low back pain, and the at-risk depression category and grade 1 low back pain.

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Common Symptoms Of Chronic Back Pain And Depression

As stated above, chronic back pain is back pain that persists for three months or more. It may worsen over time as your body develops a sensitivity to it. This may change your pain perception and cause you to experience pain in areas that were fine in the past.

Chronic back pain can also lead to the snowball effect where it interferes with sleep and in turn, leads to a loss of productivity and reduced daily function. In time, the snowball effect can cause irritability and socialization issues.

Now let’s talk about depression. The most common symptoms of this mental health condition include fatigue, insomnia, loss of appetite, irritability, and social withdrawal. Depression can also lead to frequent feelings of despair or worthlessness.

Is There A Cycle

Pain provokes an emotional response in everyone. If you have pain, you may also have anxiety, irritability, and agitation. These are normal feelings when you’re hurting. Usually, as pain subsides, so does the stressful response.

But with chronic pain, you may feel constantly tense and stressed. Over time, the stress can result in different emotional problems associated with depression. Some of the problems individuals with both chronic pain and depression have include:

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Treating Chronic Back Pain And Depression Comprehensively

There is a treatment for back pain and depression at the same time. Be that as it may, its vital that the medical professional you are working with knows both depression and lower back pain are present so that they can come up with the appropriate plan.

If you only tell them that you are depressed, they may provide prescription medication to alter your mood and suggest counseling, not knowing that your back is keeping you from living your life. Then, when things arent getting any better due to a lack of both a prescription medication for back pain and depression, it can be highly confusing for everyone.

Instead, there need to be several different treatments included in the plan to ensure the best results. Some appropriate treatments for depression include:

• antidepressant medications

When comparing depression and back pain treatment, you can quickly see similar treatment options for both problems. For example, regular exercise and a proper diet. Moreover, depression, back pain, and sleep are also related, as sleep is used to treat both conditions.

These mutual treatment options should be implemented first, and then if additional help is needed, the others can be added in. Its always recommended to start with the least invasive method to reduce the risk of side effects and other issues.

Subject Characteristics And Prevalence Of Low Back Pain

Subject characteristics including gender, age, prevalence of LBP by grade, and scores on the Zung Depression Index and Modified Somatic Perception Questionnaire are reported in Table 2. The grade of low back pain as a function of gender is illustrated in Table 3. It should be noted that 27 subjects elected to not disclose their gender and were excluded from the analysis of low back pain and gender. Similarly, 28 subjects elected to not to disclose their age. Notably, a total of 49% of the population were classified as grade 0, 24.9% of the population were classified as Grade 1, 5.4% of the population were classified as Grade 2, and 20.7% of the population were classified as Grade 3. There were more females than males in the subject sample, resulting in more females in each category of low back pain grade. The percentage of each grade within genders was quite comparable, although there were 10.5% more males in the grade 0 category, and 6.9% more females in the grade 3 category. Ninety five percent of subjects were between the ages of 17 and 20.

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Tips To Help Cope With Chronic Pain And Depression

Depression plays a significant role in chronic paintaking just a few steps to get ahead of it can help patients appreciably by giving them more control over their personal situation.

For some people, the stress and depression resulting from chronic pain can become consuming, and have the potential to significantly worsen and prolong the pain. Increased pain can, in turn, lead to increased stress and depression, creating a cycle of depression and pain that can be difficult to break.

See Depression and Chronic Back Pain

How Does Talk Therapy Help

In cognitive therapy, a person learns to notice the negative “automatic thoughts” that surround chronic pain. These often are distortions of reality. Some time with a therapist can teach you how to change these thought patterns and make you feel better.

It’s also a proven treatment for depression and can reduce symptoms of anxiety in those with chronic pain.

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How Are Depression And Back Pain Linked To Covid

Depression due to the ongoing pandemic has been present and increasing in many people. Thats because many of us are facing stressful challenges. For instance, we all know that social distancing is crucial to reduce the spread of the virus, but it also makes us feel isolated and lonely, increasing depression and anxiety.

However, what you might not know is that apart from depression, muscle aches and back pain are also related to COVID-19, as reported by many people who have already been victims of the virus. Generally speaking, back pain alone isnt typically a COVID-19 symptom. But it may be an indication of the virus if its accompanied by:

• general muscle aches
• shortness of breath

In fact, COVID-19 patients may feel muscle pain and body aches, in the upper and lower back, due to the bodys inflammatory response.

S To Proactively Address Depression

Following are several steps to help proactively prevent or manage both the chronic pain and associated depression that may develop:

• Muscle tender points
• Sleep disturbance and fatigue

In many stress-related back pain cases, patients complain of the pain “moving around” or becoming noticeably worse either just before, during, or just after a stressful event or experience.

Chronic pain can also be exacerbated by things such as physical de-conditioning due to lack of exercise and a persons thoughts about the pain. An appropriate exercise program and practicing distraction, guided imagery, and other cognitive techniques, are all effective coping techniques that can help prevent the pain from worsening.

Recognizing how stress affects pain provides the ability to lessen pain without pain medications some level of empowerment over chronic pain.

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How To Help Someone With Chronic Pain And Depression

Fortunately, there is something you can do to help people around you struggling with this issue. When depression and low back pain are combined in someone you know, the best thing to do is advising them to work with a doctor, as thats vital in their situation. We also recommend taking look at some helpful resources such as:

• The American Pain Foundation
• The American Chronic Pain Association
• The Academy of Cognitive Therapy

Moreover, another option for those struggling with back pain and depression is engaging in therapy to talk about their problems. This can now be also accomplished with the help of many online therapy sites.

What Helps Back Pain

Treating pain can help patients return to normal both physically and mentally. Certain medications and therapies can target both pain and depression. Patients benefit the most when chronic pain and depression are treated together. A few treatment options include:

• Cognitive behavioral therapy. This type of therapy addresses negative thinking patterns and teaches patients coping skills to manage depression and pain.
• Relaxation training. Because stress aggravates the pain and increases symptoms of depression and anxiety, relaxation training works to reduce stress.
• Physical therapy. A physical therapist can help improve mobility, reduce pain, and improve mood by teaching techniques for muscle relaxation.
• Exercise. Physical activity can improve mood and decrease pain.
• Group therapy. Self-help groups provide psychological support for dealing with pain and depression and anxiety. Support groups can be local to your area or found online.

Between 30 and 50% of people who suffer from chronic pain also struggle with depression and anxiety. Chronic pain can influence a persons thoughts and moods in a big way. Patients who suffer from severe back pain, for example, may isolate themselves from others, feel increased stress and feelings of worthlessness. This cycle is hard to break.

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Treating Depression Can Help Manage Chronic Back Pain

The treatment of the kind of depression linked to chronic back pain demands a more specialized approach. Typically, both should be treated at the very same time and in a multidisciplinary fashion. The treatment of clinical depression, more often than not, should include psychological interventions things like relaxation and mindfulness training, counseling and antidepressant medication.

Although the results of the latest studies do seem promising, it remains unclear whether common genetic factors lead to people developing both chronic back pain and depression. Additional studies, involving participants who are followed up with overtime ideally twins are still needed.

In the meantime, remember to take it easy on your lower back especially while lifting the garbage. And while youre at it, be sure to look after your own mental health by enjoying healthy foods, activity and keeping in touch with your friends and family.