Depression plays a meaningful role in chronic back pain – taking a few preventative steps can help patients significantly by giving them more control over their condition.
For some people, the depression and stress resulting from chronic pain can become all-consuming, and have the potential to prolong and significantly worsen the pain.
Increased pain can, in turn, cause increased depression and stress, creating a cycle of depression and suffering that can be hard to break.
Chronic Pain is Unique to the Individual
Chronic pain is defined as any pain that persists for more than 3 – 6 months.
This type of pain is also referred to as chronic benign pain or “chronic non-cancer pain.”
Neck and back pain can become chronic in several ways.
Examples include the following:
- It is possible for a patient’s pain to either continue or become worse after spine surgery. When this happens, it is referred to as failed back surgery syndrome.
- Extended pain appears to set up a pathway in the nervous system that delivers pain signals to the brain, even if there is an absence of any underlying anatomical problem in the spine. The pain is itself the disease in such cases.
- Some chronic pain may be due to an identifiable anatomical problem, such as spinal stenosis or degenerative disc disease, that can cause constant pain despite treatment attempts.
With any chronic neck or back pain, it is important to be cognizant of the potential development of depression, as depression can worsen and prolong the pain.
Health professionals will often refer to a patient’s “suffering,” which is the physical pain combined with the emotional component (e.g. depression).
Two Steps to Address Depression Proactively
Following are some steps to help manage or proactively prevent both the chronic pain and the associated depression that may develop:
Early identification of depression associated with pain.
Many physicians are not trained to look for depression during pain treatment.
Speaking to a Chiropractor about symptoms of depression, while still in the acute pain phase, can alert him or her to the need for treatment of both conditions.
While one patient may experience a full recovery from the initial period of acute pain, a patient who shows signs of or is more prone to stress and depression, or with a history of clinical depression may be more susceptible to developing a chronic pain problem that lasts beyond the initial acute pain phase.
A knowledgeable physician can recommend a treatment plan that addresses the patient’s depression as well as their physical pain and discomfort, giving the patient the best chance at a good outcome.
It is advisable to speak with a doctor if any of the following common symptoms of depression are noticed:
- An anxious or sad mood
- An increased or decreased appetite
- Difficulty falling and staying asleep
- Feeling of hopeless or lack of interest in activities previously enjoyed
- Lack of motivation or low energy
Similarly, individuals should speak with their doctors if they believe they are exhibiting symptoms characteristic of stress-related back pain, which are comparable to those of fibromyalgia:
- Back pain and neck pain
- Muscle tender points
- Diffuse muscle aches
- Fatigue and sleep disturbance
In many stress-related back pain cases, patients describe pain associated with “moving around” or pain that becomes considerably worse either just before, during, or just after a stressful experience or event.
Chronic pain can also be heightened by things such as physical deconditioning due to lack of exercise and a person’s recurring thoughts about grief.
A proper training program and practicing distraction, guided imagery, and other cognitive techniques are all excellent coping strategies that can help prevent the pain from becoming worse.
Identify stress triggers that can increase chronic pain.
Recognizing stress triggers or emotional triggers that cause additional pain is the first step in helping manage pain—at least in part—by helping the individual learn to avoid or eliminate these triggers.
For example:
- A person does not plan ahead for appointments causing him or her to be habitually late.
- A couple develops a pattern of discussing stressful issues just before bed.
This “stress” results in increased pain. Establishing a behavioral strategy for being early to appointments, and relaxing once there, can go a long way toward resolving this stress and the pain exacerbation.
This is adequate time and pain management.
Patients can monitor how their stress and anxiety affect their back pain by keeping a diary of when their back pain changes and what kinds of pressure could be triggering the pain.
This exercise can provide an identification of the elements in one’s life that affect the pain.
Recognizing how stress affects pain provides the ability to decrease pain without prescription pain medications and some level of empowerment over chronic pain.
