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Ending the Vicious Cycle of Chronic Back Pain and Depression

woman-in-park-with-guitar-and-bookBack pain can be crippling. It’s difficult to get out of bed, you can’t take part in the activities you used to enjoy, and you may feel like you’re trapped. Depression can be much the same—and it certainly doesn’t help to suffer both simultaneously. One very real danger of chronic back pain is that it often leads to depression. In fact, depression is the emotion most frequently reported by people suffering from back pain. Statistics illustrate the seriousness of this issue: Close to 31 million Americans suffer from lower-back pain at any given time. Nearly half of all people who suffer from chronic back pain also report symptoms of depression, and some researchers suggest that this number is as high as 85%.

With chronic pain, it’s not unusual for heightened levels of tension and anxiety to become constant. As time passes, this unrelenting stress can trigger a wide variety of symptoms often associated with depression. Patients may experience exhaustion, sharp mood swings, reduced self-esteem, and relationship problems as well as general physical decline, sleep disorders, and weight gain (or loss).

And while the healthcare community generally recognizes that chronic back pain can cause depression, there is also some evidence that it can happen the other way around, too–that depression can cause chronic back pain. Physical symptoms are actually quite common in people who suffer from depression. A study conducted by the World Health Organization (WHO) found that of the 1,146 patients surveyed and diagnosed with depression, 69% reported that physical symptoms were the only reason for their visit to the doctor. Given this fact, it’s not surprising that false diagnoses are also quite common.

Writes Dr. Marc Browner, a chiropractor and co-owner of Windmill Health Center in Weston, Florida, “This link between back pain and depression is believed to be caused by a shared neurological pathway. The brain moderates pain stimuli by releasing serotonin and norepinephrine, which also play a role in affecting mood. People with a neurotransmitter dysregulation may also exhibit an imbalance of serotonin and norepinephrine, which can lead to a heightened sensitivity to pain. This suggests that there may be a chemical reason why people diagnosed with depression also complain of physical pain, especially in their joints, neck, and back.”

So how to end this vicious cycle of chronic back pain and depression? When dealing with both depression and back pain, it is important to:

–        Remember that the two are often inextricably linked. Many healthcare professionals believe that you cannot reliably address both conditions by treating only one. “Rather, it is best to treat both conditions simultaneously for the most effective results,” notes Dr. Browner. He continues, “A study published in the Journal of the American Medical Association found that combining antidepressants with a pain management program was an effective way to relieve both depression and pain.” You and your doctor (or doctors) must create a treatment plan that targets both issues simultaneously.

–        Use all the tools at your disposal. Depending on your specific situation, this may include chiropractic adjustments, spinal decompression, massage therapy or laser pain relief treatments. It may also include supervised stretching, exercise or nutritional programs. Finally, your healthcare team may recommend stress management or relaxation techniques as well as counseling sessions and/or antidepressant medications.

–        Try to normalize your life as much as possible. Says “Multidisciplinary treatment of the chronic back pain and major depression will ultimately give the patient more of a sense of control over the pain and start a ‘positive spiral’ toward physical and mental re-conditioning.”

If you’re dealing with chronic back pain and depression (whatever the underlying cause), having a multidisciplinary healthcare team to guide your recovery may be your best option. However, seeking holistic treatment like this may seem like a very tall order. Don’t be afraid to consult with your general practitioner and chiropractic physician about your condition and to ask for their advice and help in coordinating care. The sooner you get the treatment you need, the sooner you can get out of pain and start living your life again!

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