Can Depression Cause Back Pain?

The Chicken Or The Egg - Depression Or Back Pain...Which Came First?

The Short Answer –

Depression and back pain are frequently linked. But the real question is which comes first – is depression the cause of back pain or is back pain the cause of depression.

The answer is both, but in different circumstances. We’ll explore this relationship below.

Can Back Pain Cause Depression?

Absolutely – and it’s well proven.

This is especially true for those with chronic back pain (lasting more than 3 months). Coping with even simple tasks can become very difficult and a genuine trigger for a deep clinical depression.

People suffering with chronic back pain typically find some of the most depression-inducing effects…

  • Difficulty moving around and taking part in active hobbies etc
  • Permanent focus on the pain, leading to distraction and an inability to concentrate on other activities.
  • Difficulty sleeping leading to prolonged tiredness and general exhaustion.
  • Trouble maintaining long-term relationships due to a lack of sexual desire and a short temper from a lack of sleep.

Frequently anti-inflammatories prescribed for back pain can cause GI issues (sickness, diarrheoa), causing an even greater feeling of being unwell with no way out.

It is worth emphasizing the depression is a lot more than just ‘feeling low’ because you are suffering with pain.

Genuine clinical depression is a feeling of complete hopelessness, that nothing matters anymore (not even life). It is not something that can just be ‘snapped out of’ and requires genuine medical help and counselling to help healing.

A large study in 2004 by Srunin and Bodin commented at length on the considerable family consequences of chronic back pain and the implications for family life.

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But… Can Depression Cause Back Pain? (The Other Way Around)

Again – Yes.

There are two fundamental reasons why depression can itself cause back pain –

  • Depression is linked directly to an increased sensitivity to pain and a lower pain threshold.
  • Depression frequently results in a lack of activity and a sedentary lifestyle, often with other poor health choices such as smoking or drinking that can cause back pain.

Lower Pain Threshold…

Hermesdorf et al (The Journal Of Pain, 2016) studied in depth the increased sensitivity to pain and lower pain threshold. They proposed that increased pain intensity perception in depressed patients was a major reason for the development of chronic pain.

This is backed up by numerous publications – not least of which comes in the form of a review by the Harvard Medical School (https://www.health.harvard.edu/mind-and-mood/depression-and-pain), which describes chronic pain as

“…an emotional condition as well as a physical sensation”

In other words, we know that pain is processed in the brain and we know that just as positivity can reduce your perception of pain, so negative feelings can increase your sensation of pain too.

Then finally, to close the case on whether depression can actually cause back pain, a trial published in the Journal Of Pain found that people suffering with depression were FOUR times more likely to suffer with low back or neck after being depressed.

So depression really can create newly registering back pain.

The trial itself was actually carried out across 800 patients that had not previously shown any back pain whatsoever.

The Final Word –

Without getting in to the technical side of how pain affects the brain, rest assured that it does.

For this reason, we can conclude the case of can depression cause back pain with a definitive ‘yes’.

Not only does back pain have the propensity to cause depression, but depression can also create back pain through a heightened sensitivity to pain and lower pain threshold.

In the case of back pain, it is more the chronic pain that causes depression, not just a muscle strain, but if you suffer with depression then all forms of back pain are possible.

Furthermore, the typical lifestyle of someone suffering with back pain is also highly conducive to developing further back pain.

So yes, depression can definitely cause back pain.

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References Used –

1. Srunin L and Bodin, LI. (April 2004) Family consequences of chronic back pain. Social Science and Medicine.
2. Marco Hermesdorf, Klaus Berger, Bernhard T. Baune, Jürgen Wellmann, Ruth Ruscheweyh, Heike Wersching. May 2016. Pain Sensitivity in Patients With Major Depression: Differential Effect of Pain Sensitivity Measures, Somatic Cofactors, and Disease Characteristics. The Journal Of Pain.
3. Harvard Health Publishing. Depression and pain.
4 Carroll LJ, Cassidy JD, Côté P. (Jan 2004). Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Journal Of Pain.

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