Treating Back Pain And Depression Requires A Thorough Approach
Those with depression seeking treatment for their back pain typically think if they can get rid of their back pain, they will also rid themselves of their depression. To some extent, that might be true. However, once you fully understand how interconnected depression and back pain are, it makes sense to treat both simultaneously. That is especially true for patients considering back surgery to give them the greatest potential for the best results.
Treatments for back patients also experiencing depression might include psychological counseling, relaxation training, and behavioral therapy. Furthermore, some medications can also reduce depressive symptoms and back pain because they work within the brain to boost their mood and pain perceptions.
Another way to treat depression and back pain together is through aerobic exercise, which stimulates serotonin levels in the brain and spurs the release of endorphins to relieve both depression and pain. However, you must always consult with a doctor before beginning an exercise program.
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
Can Depression Cause Back Pain
It can work the other way around as well, which implies that they can feed into each other in a vicious circle.
Research shows that people who score in the highest 25% of depression scores have four times the risk of experiencing neck or low back pain. To quote the study from the scientific journal Pain: Depression is a strong and independent predictor for the onset of an episode of intense and/or disabling neck and low back pain.
Again the causes arent always clear, and in some cases, it could be linked to sensitization of the nervous system for example. But as before, some reasons are pretty obvious.
Depression can make you less active. And inactivity is a big factor behind many cases of back pain, and physical aches and pains in general. Your body is built to move around, and when it doesnt, it complains. I believe that a lot of physical discomfort is the body protesting that its not being used the way its meant for. Such as walking and running, bending and lifting, pushing and pulling, and moving things around.
There are antidepressants of course, and some studies have shown that tricyclic antidepressants might also help reduce low back pain.
But those medications might not be suitable for everyone, and its up to your doctor to decide if its right to prescribe them.
You May Like: Causes Of Major Depressive Disorder
Psychological And Social Factors Not Only Affect Back Pain Itself But Also How Much The Pain Impacts Ones Life
1.Psychological factors are commonly associated with chronic low back pain
Psychological and social factors not only affect back pain itself but also how much the pain impacts on ones life. For example, the presence of depressive symptoms can make back pain worse and increase the disability associated with back pain . People with back pain are more likely than people without back pain to meet criteria for common mental health problems, including major depressive episodes, anxiety disorders . The coexistence of mental health conditions with back pain is associated with impaired quality of life and increased risk of chronicity . While mechanisms underlying these associations are not fully understood, treatments of chronic back pain have expanded to include relevant psychological processes.
Some well-known psychological risk factors for back pain onset and maintenance
2. Avoidance behavior in response to chronic pain may be unhelpful and contribute to pain maintenance
3. Behavioral overactivity and dysfunctional persistence can also hinder healing process and increase functional limitations
Just as avoidance behaviors can lead to pain chronicity, so can the opposite patterns. It appears that behavioral overactivity and dysfunctional persistence with activities despite severe pain can hinder healing process and lead to increased pain and functional limitations .
Selected psychological approaches in global back pain treatment
Psychological protective factors
More Than Just Back Pain
Many people are surprised to learn that theres a link between back pain, depression, and anxiety. This has been supported by numerous studies, including one in 2017, which utilized Canadian college students as participants. This study discovered that back pain from depression is most common for those aged 18 26, but of course can occur at any point in ones life. This age range is not surprising, considering its a time when young adults have significant life changes from starting families to beginning careers. Statistically, this is also an age range when depression rates can be very high.
A study at the University of Sydney found that the more depressed a person is, the more severe their back pain. Treating back pain from depression or anxiety can be challenging because the cause is different than other types of pain. There isnt a physical trauma to treat. Its thought that depression causes back pain because you have less serotonin when youre depressed. This affects your body as well as your sleep, social ability, and overall activity levels.
When not caused by an identified trauma, chronic back pain often has a mind-body overlap. Its not in your head because back pain from depression does result in an actual physical problem. Rather, the problem persists or is worse because of emotions. Ultimately, depression and anxiety can make the pain a lot worse than it should be.
Recommended Reading: Medication For Depression And Adhd In Adults
Emotional Causes Of Sciatica
The sciatic nerve is the longest and widest nerve in the human body, running from the lower back down the legs. Sciatica is a term used to describe the symptoms of pain, tingling, and numbness that can radiate from the low back and down the legs. Sciatica is caused by compression or irritation of the sciatic nerve. This can be caused by a variety of things, including a herniated disc, bone spur, or muscle spasm. Emotional causes of sciatica are not well-understood, but it is believed that stress and anxiety can contribute to the development of sciatica.
The main sciatic nerve runs down the back of the leg, causing knee pain. The effects of stress, fear, and other emotional issues on your entire body can be felt in a variety of ways. A Sciatica is a joint ache or numbness that occurs in the legs, lower back, or buttocks. The sciatic nerve runs down the back of your legs, and it can cause pain or other symptoms if you restrict or injured the nerve. Massage and other forms of neuromuscular therapy can be beneficial in a stressful environment. Massage therapy for sciatic pain can be improved through the use of other techniques.
Data Collection And Analysis
Data items and data collection process
Data extraction forms will be drafted and pilot tested. A training exercise will be conducted using a random sample of five articles to pilot test the standardized data abstraction form involving all reviewers and assess for at least 80% agreement before starting full data extraction. The lead author will extract data from eligible studies to build evidence tables. A second reviewer will independently extract study results and any disagreements will be discussed to reach consensus. A second reviewer will verify all other data extraction items by checking the extracted data to minimize error.
Data will be extracted from each study on author, publication year, study design, setting and participants , duration of follow-up, definition of exposure and outcomes, comparison groups, effect sizes and 95% confidence intervals from unadjusted and adjusted analyses, and covariate information . Effect sizes include risk ratios, rate ratios, odds ratios, hazard ratios, and mean differences. Authors will be contacted if there is missing information in the studies, such as effect estimates or raw data. However, if this information is still missing after attempted contact, these study results will be described separately based on available information .
You May Like: Why Do I Miss My Depression
If Your Body Hurts A Lot Lately This Could Be Depression
If you have a pre-existing pain situation, such as carpal tunnel syndrome or sciatica, the onset of depresson can worsen the pain from these conditions.
The physical pain from depression is very real.
We can think of depression as a heightened sensitivity to difficulties in life, says Patricia Celan, MD, a senior psychiatry resident at Dalhousie University in Canada.
When depressed people receive criticism, they may beat themselves up about it more than others would.
When depressed people have a night of bad sleep, their energy is lower the next day compared to someone else.
This works the same way with pain something that may be mildly painful for one person is significantly more painful when depression is added to the picture.
It all comes down to higher brain activity in the amygdala, which is the brain area predominantly involved in emotions, and less activity in other brain areas that can compensate.
Both therapy and antidepressant medication can change the way a persons brain responds to the surrounding world in many ways, from how people interpret criticism to how they interpret pain.
For example, cognitive behavioral therapy can treat pain even without adding medication and that therapy can also treat depression.
Physical Symptoms In Depression
Physical symptoms are common in major depression and may lead to chronic pain and complicate treatment. Symptoms associated with depression include joint pain, limb pain, back pain, gastrointestinal problems, fatigue, psychomotor activity changes, and appetite changes. In the primary care setting, a high percentage of patients with depression present exclusively with physical symptoms. Simon et al.1 analyzed a World Health Organization study of somatic symptoms in the presentation of depression. Of the 1146 patients in 14 countries included in the survey who met the criteria for depression, 69% reported only somatic symptoms as the reason for their visit. Unfortunately, depression can often go undiagnosed in these patients, as the physical symptoms associated with depression may be interpreted as symptoms of a somatic illness.
Physical Symptoms as a Predictor of Mood Disordersa
In general, the worse the painful physical symptoms, the more severe the depression. Physical symptoms have been found to increase the duration of depressed mood. In a study of chronic pain as a predictor of depressive morbidity in the general population, Ohayon and Schatzberg3 found that of the study participants who reported at least 1 key symptom of depression, those with a chronic painful physical condition reported a longer duration of depressed mood than those without chronic pain .
Don’t Miss: Feeling Too Depressed To Do Anything
Why Depression Targets Your Back
Depressed people have lower levels of serotonin and other brain chemicals. This affects your physical body. It also affects your activity, sleep, and social interactions.
Back pain is known to happen with depression, anxiety, stress, and sleep disorders. Most chronic back pain has a mind-body connection. The mind-body connection means that a real physical problem exists but emotions play a large role in that experience. Mind makes the pain worse or better than it is.
A depressed person usually endures a lot more emotional pain that someone who is healthy. That emotional pain manifests throughout the body as aches and pains. The lower back muscle is not very strong. Repeated stress, anxiety, and emotional trauma are par for the course in depression. These all take their toll on the lower back muscle. Why?
Trauma and anxiety activate your bodys inflammatory system. Your lower back muscle becomes inflamed to protect itself from outside attack, regardless of whether there is any physical outside action. If you repeatedly experience anxiety, stress, and trauma you create muscle memory in your body. Your lower back can only handle so much muscle memory, before something gives.
What Are The Most Common Causes Of Depression
There are many causes of depression. It may be that the person is depressed because they cant participate in their favorite activity such as golf, tennis, cycling, hiking, or just working out.
Dr. William Nelson, of Explore Health located in Scottsdale, AZ is an expert on identifying and treating the cause of your depression whether it is due to lack of hormones adrenal and/or thyroid disorders, lack of neurotransmitters, previous emotional of physical trauma, or complicated by alcohol use disorder, or addiction to opiates. He understands the importance of addressing physical and emotional pain and has great success utilizing the concepts of Mind-body medicine
Read Also: Mental Health Services For Depression
Digestive Problems Or Irregular Bowel Schedules
Digestive problems, like constipation and diarrhea can be embarrassing and uncomfortable. Often caused by food poisoning or gastrointestinal viruses, itâs easy to assume that gut discomfort stems from a physical illness.
But emotions like sadness, anxiety, and overwhelm can disrupt our digestive tracks. One 2011 study suggests a link between anxiety, depression, and gastrointestinal pain.
Why Chronic Back Pain Is Connected To Your Head
When your physical movement is limited, this can cause psychological distress, and the psychological distress can, in return, worsen the pain. Your personal health beliefs and coping strategies can influence both your level of distress and course of the pain. For instance, if you are anxiety-prone, expect the worst, and have catastrophic thinking, this can make the pain far worse. Thats because those psychological vulnerabilities can change your brain and intensify the pain.
Often, if you have these pre-existing psychological attitudes, you also have abnormalities in the regulation of your brains chemistry , and the usual brain functions in emotional control, anxiety, and attention are also disrupted. As a result, you cant control your distress your become anxious you expect the worst and you cant focus on anything else. The pain becomes all-consuming.
But its not just pre-existing attitudes that worsen back pain. The pain itself can rewire your brain. When pain first occurs, it impacts your pain-sensitivity brain circuits. But when pain lasts, the related brain activity switches away from the pain circuits to circuits that process emotions. Thats why emotions like anxiety often take center stage in chronic back pain. And its why emotional control becomes that much more difficult.
Recommended Reading: I Wake Up So Depressed
Speak To The Back Doctors At New Jersey Spine & Orthopedic Today
If you are experiencing back pain and depression, do not hesitate to contact the back doctors at New Jersey Spine & Orthopedic. While back pain might go away on its own, it may take longer if you also suffer from depression. Our board-certified back doctors have experience handling various back and spine conditions and will do everything possible to eliminate your discomfort. To learn more about our services, call or complete our online contact form.
But How Does Anxiety And Depression Fit Into That Pattern Is It Any Different
When we become depressed we might be lethargic, sad, anxious, worried and fearful of the future. We can find ourselves in a repeat loop a seeming endless cycle of frustration and melancholy.
At the bottom of this pit of despair can lie basic assumptions that we are making about our past and our future. The present might seem like a painful place as we agonise about what has been, and what is to come.
Our muscular reactions are no different than in the flight, fight or freeze response we are, in effect reacting to an internal stimulus that is telling us we have reason to be fearful. And like the sabre tooth tiger in the aforementioned post, it can hurt us so we freeze, or panic in order to try to combat that fear.
This leads to deep muscle tension, muscle stiffness, chronic back pain, neck pain, shoulder pain, frozen shoulders and back spasms.
Don’t Miss: Can I Go To A Walk In Clinic For Depression
Can Stress And Anxiety Cause Sciatica
Stress and anxiety are common mental health disorders that can have a profound effect on your physical health. While the exact cause of sciatica is unknown, it is believed to be caused by a variety of factors, including stress and anxiety. Stress and anxiety can contribute to the development of sciatica by causing the muscles in your back and pelvis to tighten and spasm. This can put pressure on the sciatic nerve, which runs from your lower back through your buttocks and down your leg. Stress and anxiety can also make it difficult to manage the pain of sciatica, which can lead to further complications.
When you have a sciatic flare-up or an episode, it is possible to experience blinding pain. When it is so intense that it causes a panic or anxiety attack, it could be a painful condition. As a result of an anxiety attack, the nerves that have already been weakened by sciatica are under even greater stress, causing many to fail. Rest and exercise are essential for stress and anxiety reduction. Consider speaking with someone who is experiencing anxiety, sciatica, or both. The proper diet and exercise can help you relax and reduce pain as a result of increased stress. If you have any concerns about your next visit with your doctor, make a list of things you would like to say.