Back Pain and Depression

Research shows a connection between depression and back pain, but help is available.

Health research professionals have studied the connection between back pain and depression for many years. And unfortunately, I see this vicious cycle play out in countless patients throughout my career. Especially during this pandemic, when chronic pain can already feel like such an isolating and “invisible” to everyone-but-the-person-battling-it condition, I want people to know they are not alone.

The pain is real. Studies suggest that people with severe depression may feel more intense pain episodes than those who don’t have depression. Sometimes the question becomes a “which came first, the chicken or the egg?” philosophical debate. Did the depression cause severe back pain? Or did the chronic back pain cause feelings of depression? The truth is, it doesn’t matter. The problem is real and is the body’s way of signaling that something is wrong. Getting to the bottom of the pain and depressive symptoms is necessary for healing, plain and simple.

Chronic pain is hard. Especially for those who have been battling back pain for a long time, constant pain is difficult and can lead to feelings of depression. If you aren’t someone who has lived with ongoing pain for three months or longer, it can be tough to wrap your mind around the concept. But I have treated people who have lived with debilitating back pain for YEARS, and I have seen the toll it can take not only physically but mentally as well. If you are battling chronic pain that isn’t well-controlled, I understand what an uphill climb it can feel like. 

The calendar may play a role. When days are shorter, studies indicate that depressive episodes increase. This phenomenon can also lead to an uptick in back pain episodes. Again – it’s a vicious cycle. Add to it the inherent stress that the winter months can bring – namely, with the holidays’ overexertion and exhaustion. Back pain or not, depression or not, the winter months can be difficult for many people.

Help is available. Consider speaking to a mental health professional regarding your thoughts and feelings. Or consult with a spine specialist about your back pain. In fact, you may want to consider doing both. The point is: help is out there. Even during this pandemic, a wide range of providers are doing an incredible job of bringing their patient care virtual. So don’t let COVID stop you from getting the help you may need. It is available, even from the comfort and safety of your own home. One important recommendation I have for anyone who is battling back pain and feelings of depression is to find a health provider with whom you can be sincere and honest. A history and physical, diagnostic lab work, and imaging studies doesn’t paint us a complete picture of depression and back pain. We can’t help in meaningful ways unless we have an accurate picture of how you’re doing – regardless of what the “tests” tell us.

It is also important to highlight here that seeking help is not a sign of “weakness,” nor will it automatically require you to take medication or undergo spine surgery. There are so many available “treatments” today that involve neither, and they can be a great place to start. These can include stress-reduction techniques and pain rehabilitation programs, to name just a couple of effective options.

You might be surprised to learn that back pain can sometimes be the only sign for the person experiencing it that they are dealing with depression. While that may be comforting to know, it remains crucial to have these symptoms evaluated by a health care professional. Please don’t be embarrassed or shrug it all off as “no big deal.” The earlier you seek treatment, the easier and faster that treatment usually is. “Toughing it out” is not a recommendation from any doctor worth their medical license. We have training in delivering healing to people who are hurting. So, please let us help. And remember, even during this time of winter, when it might seem dark and isolating, I promise you are not alone.


Neel Anand MD

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